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Report Title:	Formative Research for a Campaign to Promote Healthy Weight Using Relevant Physical Activity and Nutrition Messages for Youth: Healthy Weight, Physical Activity, and Nutrition: Focus Group Research with African American, Mexican American, and White Youth - Executive Summary
*Abstract:*	This report summarizes a collaborative qualitative research study conducted by the CDC’s Division of Nutrition and Physical Activity (DNPA). Research goals included understanding how peers, family, and the media shape youth attitudes about physical activity and healthy eating, exploring how youth process information in a cluttered media environment, and developing a comprehensive physical activity and healthy eating consumer profile of youth.
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Agency:	Centers for Disease Control and Prevention
Date of Report:	6/1/2000

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Report Title:	Message Strategy Research to Support Development of the Youth Media Campaign (YMC) Revealing Target Audience Receptiveness to Potential YMC Message Concepts
*Abstract:*	According to target audiences, self-esteem or feeling good about yourself is the primary force that enables tweens to resist involvement in behaviors that could be damaging to their health both now and in the future. Having high self-esteem is said to give tweens the confidence to resist pressures that influence them to engage in unproductive or harmful behaviors. Kids who feel good about themselves say they don’t need to use drugs or smoke cigarettes to feel cool, whereas those with lesser self-esteem appear to make bad choices as a means of achieving self-esteem. Tween perspectives on Involvement A variety of important factors are said to influence or establish a tween’s self-esteem. These factors include: 1) having a sense of purpose ,which is achieved by finding an activity they are passionate about and can excel in; 2) feeling a sense of accomplishment which is achieved by setting and accomplishing goals over time; and 3) finding a source of support , which is provided through the encouragement and involvement of family and friends who show an active interest in their lives. Across all 9–13-year-olds, there appears to be various and unique psychographic segments of the tween audience that must be considered and taken into account when planning the Youth Media Campaign. These youth segments cluster along a spectrum that is based upon their degree of mental and physical involvement. The spectrum ranges from kids who are completely involved to kids that are completely uninvolved. While the majority of kids fall somewhere in between, the mindset, motivating factors, and barriers for each segment are unique, hence requiring specific message strategies tailored to the segments. For example, kids who are completely involved are typically those who are strongly involved in an activity physically and emotionally. They feel passionate about being involved in activities and see their involvement as a means to an end. They easily list goals that they are working toward, and often reveal successes they have experienced along the way. These tweens are committed to doing their personal best are confident in their ability to excel. For this segment, message strategies need to reinforce the idea that being completely involved helps you feel good about yourself and helps you achieve your hopes and dreams. On the other hand, kids who are completely uninvolved are typically those who are not involved physically or emotionally. Oftentimes, these tweens do not feel passionate about any particular activity and, as such, do things out of boredom rather than interest. In many cases, completely uninvolved youth do not have clear goals or objectives. Similarly, they have never experienced successes from which they can derive confidence. In many cases, they do not feel good about themselves or feel that they will ever be the best at anything, although they do hope to do the best they can. For this segment, message strategies need to help them find or discover their passion, providing reassurance that everyone is good at something. For the majority of kids in the middle of the involvement spectrum, many are involved but not yet emotionally connected (or passionate about) the activities in which they engage. For example, this week they’re involved in art and next week they’ll try basketball. In some ways, they are in a period of discovery, trying to find their passion or that one thing they will be really good at. Many older tweens say their involvement levels decrease as they approach their teens because their period of exploration and experimentation has been completed and because they develop other interests such as dating, jobs, and school. More importantly, tweens say that they are likely to stick with a particular activity if they ultimately discover a passion for it. A passion is said to arise when they feel personally rewarded by an activity, enjoy participating in it, and/or feel good about themselves as a result of their participation. Parent’s perspective on Tween Involvement Not surprisingly, most parents argue that they, as parents, are the most important positive influence in their children’s lives. They mention the importance of keeping the lines of communication open now so their kids will feel comfortable discussing difficult decisions with them as they grow older. Many parents say it is their responsibility to teach values at an early age so their children will be prepared to choose between right and wrong during their teenage years. Additionally, parents say they try to set a good example in the home for their kids to learn from. Some parents recognize that teachers, coaches, and other family members also influence their tween’s lifestyle. Some parents indicate that their children may be more likely to approach other adults with problems and concerns; adult influencers confirm this, saying their role is often to listen objectively to the tween, providing support parents are unwilling or unable to provide. According to both parents and influencers, it is also important that other adults set positive examples for kids. However, some parents do not assume other adults can take their place in this regard. Adult influencers agree that parental attention and support is the most important part of minimizing the risk that children will become involved in negative behaviors. Most parents indicate that the negative influences their children face far outweigh the positive. Parents reveal that there are a number of things that negatively influence their kids, including peer pressure, the media, promiscuity, gangs, and the availability of drugs, alcohol and cigarettes. Parents agree that it is important for them to be involved in their children’s activities, and many say they have made personal sacrifices in order to do so. They explain that they make an effort to attend their kids’ games, recitals and activities. Parents of uninvolved children, however are somewhat more likely to indicate that work and family commitments make it difficult for them to become involved. Many parents of uninvolved kids encourage their children to become more active and involved. However, they indicate that many factors affect whether their children will actually do so. These include: 1) talent, that is, their tweens have given up on various activities because they “weren’t very good,” 2) interests, that is, their tweens are interested in other things like creative and performing arts, and/or 3) injuries and chronic health problems exist, such as asthma. Out of the message concepts that were evaluated with tweens, parents, and influencers, messages that focus on the idea of finding something you are good at appear to be most appealing and meaningful. According to tweens, the concept’s appeal is said to lie in the opportunity to discover what is right for you. Regardless of gender, ethnicity, or level of involvement, tweens say they are drawn to the idea of making their own discoveries about themselves and finding a way to be their best. On the other hand, when messages suggest that being involved and active will allow them to be a star or be with other kids like themselves, some tweens balk, identifying these ideas as not relevant or important. Similarly, completely involved tweens respond to some messages differently than completely uninvolved tweens. Completely involved tweens appear to be more receptive to emotional messages that blatantly draw a direct connection between being active and feeling good about yourself or making good choices. These messages appear to be less appealing and relevant to those who are presently uninvolved and may have lower self-esteem. Messages that focus on the belief that every child can be good at something resonate most favorably with parents. Nearly all parents say they want to help their child discover his or her talents, to make good choices, and have fun along the way. While messages that relate to helping tweens learn lessons such as respect and discipline through involvement also appeal to parents, several other prototype messages do not. For example, parents reject messages that associate activity with life-long health benefits for their child. According to many parents today, their challenges of parenthood are focused on ensuring their kids health and safety today, not 20 years from now. Similarly, many parents suggest that because so many other factors can affect their child’s health, a correlation between activity and good health is not guaranteed. Parents also react less favorably to messages that suggest they can feel proud of their children when they participate in activities; most say they feel proud of their children regardless of whether or not they participate. Lastly, parents react negatively to messages that remind them of the difficulty or challenges of parenting; many say they don’t need to be reminded of these challenges in order to relate to a message. Perspectives on Involvement from Adult and Tween Influencers Industry experts provide a variety of insights and suggestions to guide CDC in its campaign development effort. These ideas focus on giving tweens a voice in campaign development and securing the support of parents and community-based organizations. More specifically, they suggest that CDC: - Give tweens a voice. Experts suggest that successful youth marketers give tweens opportunities and outlets to express themselves, which helps establish a relationship between the brand/, the message, and the tween. These marketers say tweens seem to respond positively to programs that have various mechanisms for feedback. According to these experts, this effort shows tweens that this company values what I have to say. Additionally, successful youth marketers say they actively seek out feedback from tweens from tweens on an ongoing basis and use this data to update and/or drive future programming and messages. - Appeal to tweens through reflections of their everyday life. Experts agree it is important to accurately portray the day-to-day events and issues tweens face. According to these experts, tweens respond to familiar settings, and language, and kids that they can identify with. - Continuously monitor and update communications according to the wants and need of tweens. Experts indicate that an ongoing commitment to tween-focused research is necessary to ensure that communications are relevant and cool to this ever-changing audience. Experts explain that it is necessary to continually evolve with tweens, which requires constant feedback and research. Some suggest that talking to tweens in focus groups is an ideal method of gathering feedback; some organizations report conducting 250 –300 focus groups with tweens each year. - Respect tween individuality. When it comes to marketing to tweens, experts remind us that one size doesn’t fit all. Experts also indicate it is important to recognize the diversity of this generation. According to them, messages should include tweens from different cultures, ethnicities, backgrounds, and family compositions. Not all tweens look alike, talk alike, or wear the same clothes. Many experts say tweens will be better able to identify with a character or message that relates to their personal experiences and background. - Utilize grassroots organizations for support in deliverying messages. While a national message is generally effective for raising awareness, it is unlikely that it will be enough to change behavior. Several organizations express beliefs that national efforts supplemented by efforts at the local level result in more effective communications. Successful youth marketers utilize many community-based organizations across the country as a resource to effectively reach out to the community and to bolster support for programs. Community-based organizations can lend credibility to a national campaign because they are generally well known within the community, are often trusted sources for direct outreach support services, and generally provide the personal, human factor lacking in a broad-based campaign. - Communicate effectively with parents. While they are seeking a certain amount of independence, tweens still admire their parents. Several experts underscore the importance of parents in effectively communicating with tweens. They say parents often know what they need to talk about with their kids, but need advice on how to talk to them about various issues.
	Details...
Agency:	Centers for Disease Control and Prevention
Date of Report:	1/1/2001

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Report Title:	Review of Literature to Support Development of the Youth Media Campaign: Exploring How to Motivate Behavior Change Among Tweens in America
*Abstract:*	In 2000, the Centers for Disease Control and Prevention was designated by Congress to take the lead in developing and implementing a Youth Media Campaign for changing children’s health behaviors. The purpose of this research was to assemble and document a review of literature and secondary research pertaining to topics relevant to developing a Youth Media Campaign. The review sought to compile a current and comprehensive collection of existing information on tweens (defined as youth aged 9 to 13).
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Agency:	Centers for Disease Control and Prevention
Date of Report:	12/1/2000

4

Report Title:	Addressing Cardiovascular Health in Asian Americans and Pacific Islanders: A Background Report
*Abstract:*	To promote cardiovascular health among AAPIs, the NHLBI has launched the ASPIRE for Healthy Hearts Project. This project seeks to develop model cardiovascular outreach efforts or activities which utilize strategies that are targeted to AAPI cultures, language, and traditional beliefs. As part of the assessment phase, this background report was developed to examine the needs and opportunities for cardiovascular health promotion for AAPIs. It provides an overview of the status of cardiovascular disease among AAPIs and shares knowledge gained from successful community-based projects across the country. Experience from these projects suggests that a family-based approach to health promotion is an important component of effective outreach strategies for AAPIs. In addition, it provides important program planning information (Appendices A-C) for those who are interested in promoting heart health in their communities.
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Agency:	NIH:National Heart, Lung, and Blood Institute
Date of Report:	1/31/2000

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Report Title:	Cardiovascular Risk in the Vietnamese Community
*Abstract:*	Asian Americans and Pacific Islanders (AAPIs) are the fastest growing racial/ethnic group in the United States. They have varying socioeconomic characteristics, levels of acculturation, immigration history, and health profiles. The AAPI population is extremely diverse; its members have ancestral ties to approximately 50 Asian and Pacific Islander nations. Heart disease is the leading cause of death among these groups, but its impact on each group varies. The National Heart, Lung, and Blood Institute (NHLBI) worked in partnership with the Asian & Pacific Islander American Health Forum (Health Forum) to conduct an assessement of the cardiovascular health status of four AAPIs groups nationwide. The Vietnamese community is the second of four Asian American communities studied. Other populations included in this assessment are Filipinos in Daly City and San Francisco, California; Native Hawaiians in Moloka'i, Hawaii; and Cambodians in Lowell, Massachusetts. This report focus on the Vietnamese community in Houston, Texas. Three formative research methods were used to study this community: 1) focus groups with staff and volunteers from a local community service agency; 2) key informant interviews with community leaders; and 3) indepth interviews with community residents conducted by trained bilingual facilitators. This report provides insight into the Vietnamese community's perceptions and knowledge of heart disease, and motivations to making lifestyle changes. Results of this study indicate that while Vietnamese in the United States are concerned about their overall cardiovascular health, they have little to no knowledge about heard disease or its risk factors. Many are new immigrants and do not seek proper health care services because of language barriers, confusion over the American health care system, financial difficulties, and time constraints. Intervention programs need to incorporate the values and traditions of the Vietnamese culture, be community-based, and start with the basics of taking care of one's heart health and mental health, including making good food choices and managing stress.
	Details...
Agency:	NIH:National Heart, Lung, and Blood Institute
Date of Report:	3/1/2003

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