August 2005

The VERB campaign was a multiethnic social marketing campaign that combined paid advertisements with school and community promotions and internet activities to encourage children 9 to 13 years of age to be physically active every day. Launched in 2002 by the Centers for Disease Control and Prevention (CDC), VERB used commercial marketing methods to advertise being physically active as cool, fun, and a chance to have a good time with friends. The campaign ran from 2002 through September 2006 when funding was not continued. The evaluations being summarised here focus on a selected time frame within the ongoing VERB campaign; it involved paid advertising using the VERB brand that ran nationally from June 2002 through June 2004.

VERB was based on the premise that a physically active lifestyle, if established at this young age, could lessen the decline in physical activity typically seen in the high school years, especially among girls. (Self-reported data indicate that almost one quarter of children 9 to 13 years of age engage in no free-time physical activity during a typical week, and approximately one third of high school students are insufficiently physically active - with girls less active than boys and Hispanic and black high school students less active than their white peers). In addition, the CDC reasons, active children are more likely to become active adults, which could have with immediate and long-term health benefits, including weight control, lower blood pressure, bone health, and enhanced psychological well-being.

A prospective, longitudinal, quasi-experimental design was used. A baseline survey was conducted in April to June 2002, before the launch of VERB advertising. Random-digit-dialing methods were used to survey a nationally representative sample of children and parents. The follow-up survey was repeated with the same cohort of children and parents (a total of 3,120 parent-child dyads) in April to June 2003 and in April to June 2004. To continue to assess effects in the target age of the campaign, a new cohort was interviewed in 2004 (cohort 2; n=5177). Propensity scoring was used to determine the campaign's effects on awareness and physical activity behaviours.

The 2-year period of the campaign being evaluated here produced high levels of awareness, based on a 5-category measure of reported frequency of seeing the campaign. Among 9-13 year olds in cohort 2, 81% reported being aware of the campaign. Of those aware, 96% had understanding of the campaign messages.

Free-Time Physical Activity and Previous Day Physical Activity


There was a statistically significant (γ=0.19, [CI: 0.11, 0.26], p <0P<.05) dose-response effect of exposure to VERB on the children reporting physical activity on the day before the interview and on the median number of weekly sessions of physical activity during free time that were reported (γ=0.09, [CI: 0.04, 0.13], p<0P<.05). Thus, as the self-reported frequency of exposure to VERB increased, so did these two indicators of physical activity. An awareness effect of VERB on physical activity was also detected. Among children aware of VERB, 61.2% [CI: 58.3, 64.0] reported physical activity on the previous day in 2004, while 45.7% [CI: 38.9, 52.5] of children unaware of the campaign reported previous-day physical activity (d=15.4 [CI: 8.1, 22.8], p<0P<.05). Children who reported being aware of VERB engaged in 3.9 [CI: 3.5, 4.2] weekly sessions of free-time activity in 2004, whereas children with no VERB awareness reported 3.0 [CI: 2.4, 3.7] sessions), a 22% difference between VERB aware and VERB unaware.

Effect sizes for the awareness effect on behavior were r=0.07 for median number of weekly sessions of free-time physical activity, r=0.12 for physical activity on the day before the interview, and r=0.06 for organized physical activity.

Psychosocial outcomes:


The VERB campaign had a dose-response effect on outcome expectations - beliefs about the benefits of participating in physical activities, as well as an awareness effect: children who were aware of VERB averaged a scale score of 10.07 [CI 10.04, 10.11] compared with a score of to 9.71 [[CI 9.56, 9.85] among children who were unaware of VERB. Positive campaign effects were detected on the two remaining psychosocial scales, social influences - influences of family and peers and self-efficacy - confidence to overcome barriers to engaging in physical activities. Because the items in these scales had not been measured at baseline, the evaluators could not use propensity scoring to achieve statistical balance as was done with other outcomes; thus, leading them to report outcome expectations as showing significant effects, but not social influences nor self-efficacy.

Email from Suzanne Gates to the Hollywood, Health & Society's Entertainment Education List Serve dated Monday August 8 2005; "Effects of a Mass Media Campaign to Increase Physical Activity Among Children: Year-1 Results of the VERB Campaign", by Marian Huhman, PhD, Lance D. Potter, MA, Faye L. Wong, MPH, Stephen W. Banspach, PhD, Jennifer C. Duke, PhD and Carrie D. Heitzler, MPH. Pediatrics, Vol. 116 No. 2 August 2005, pp. e277-e284; and Huhman ME, Potter LD, Duke JC, Judkins DR, Heitzler CD, Wong FL. "Evaluation of a national physical activity intervention for children: The VERB Campaign 2002-2004". Am J Prev Med 2007;32(1):38-43.