The effect a of community-based social marketing campaign on recruitment and retention of low-income groups into physical activity programmes - a controlled before-and-after study

BMC Public Health

Kenneth R Fox¹  Russell Jago¹  Janet Withall¹ 

[1]Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK

关键词: Economically deprived;    Low income;    Community;    Adherence;    Retention;    Recruitment;    Exercise;    Physical activity;    Social marketing;   

Others  :  1163027
DOI  :  10.1186/1471-2458-12-836

 received in 2012-02-13, accepted in 2012-08-31,  发布年份 2012

【 摘 要 】

Background

The beneficial effect of physical activity for the prevention of a range of chronic diseases is widely acknowledged. These conditions are most prevalent in low-income groups where physical activity levels are consistently lower. Social marketing is the government’s recommended approach to promoting physical activity but evidence of its effectiveness is limited. The purpose of this study was to examine the effect of a social marketing campaign on the monthly recruitment, attendance and retention levels at a community-based physical activity programme in a low income area.

Methods

A six-month social marketing campaign was designed and delivered in a highly-deprived suburban neighbourhood. Analysis of variance was used to assess effects on recruitment and attendance. χ2 tests of independence were used to compare dropouts and adherers and effectiveness of recruitment mechanisms. Percentages were used to compare adherence rates at intervention, pre-existing sessions in the intervention area and control area sessions.

Results

Attendance data were collected weekly and presented and analysed monthly to provide a view of changing participation over the six month intervention period, as compared to attendance at pre-existing sessions in the intervention area and in a control area. Recruitment into intervention sessions was significantly greater than into pre-existing and control area sessions in Month 1 (18.13v1.04 p = .007, 18.13v.30 p=.005), Month 5 (3.45v.84 p=.007, 3.45v.30 p<.001) and Month 6 (5.60v.65 p<.001, 5.60v.25 p<.001). Attendance at intervention sessions was significantly greater in all six months than at pre-existing and control area sessions; Month 1 (38.83v7.17 p<.001, 38.83v4.67, p<.001), Month 2 (21.45v6.20 p<.001, 21.45v4.00, p<.001), Month 3 (9.57v6.15 p<.001, 9.57v3.77, p<.001), Month 4 (17.35v7.31 p<.001, 17.35v4.75, p<.001), Month 5 (20.33v8.81 p=.007, 20.33v4.54 p<.001) and Month 6 (28.72v8.28 p<.001, 28.72v.4.00 p<.001). Drop-out rates in the intervention area were similar to the control area (66.2%v69.9%), and considerably lower than in pre-existing sessions (83%). In months one and two, traditional marketing techniques (posters/outdoor banners/flyers) had the greatest influence on recruitment compared to word of mouth communication (84.5%v15.5%). In months five and six word of mouth influenced 57.5% of new recruits.

Conclusions

Direct comparisons with other programmes were difficult due to a lack of standard definitions of recruitment and adherence and limited reporting of findings. However when compared to pre-existing sessions and sessions delivered in a control area, monthly attendance patterns indicated that a reasonably well funded social marketing campaign increased recruitment into exercise sessions, maintained good levels of attendance and reasonable levels of adherence. Good attendance levels support on-going campaign success by offering evidence of peer and social support for the activity and increasing opportunities for social interaction. They also increase the capacity and reach of the word of mouth communication channels, the most effective form of promotion. Further study into methods of improving exercise adherence is required.

【 授权许可】

   
2012 Withall et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Department of Health: At least five a week. Evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. Department of Health, London; 2004.
• [2]Department of Health: Be Active, Be Healthy: A plan for getting the nation moving. Department of Health, London; 2009.
• [3]Royal College of Physicians: Storing up Problems: The Medical Case for a Slimmer Nation. Royal College of Paediatrics & Child Health & Faculty of Public Health, London; 2004.
• [4]The Health and Social Care Information Centre: Statistics on obesity, physical activity and diet. England; 2009. Available online: http://www.ic.nhs.uk/webfiles/publications/opan09 webcite
• [5]Department of Health: Choosing Activity: A physical activity action plan. Department of Health, London; 2005.
• [6]Acheson D: Independent Inquiry into Inequalities in Health: Report. The Stationery Office, London; 1998.
• [7]Wanless D: Securing good health for the whole population: Final report. HMSO, London; 2004.
• [8]Hillsdon M, Panter J, Foster C, Jones J: Equitable access to exercise facilities. American Journal of Preventive Medicine 2007, 32(6):506-508.
• [9]Eyler AA, Vest JR, Sanderson B, Wilbur J, Matson-Koffman D, Evenson KR, Thompson JL, Wilcox S, Young DR: Environmental, policy, and cultural factors related to physical activity in a diverse sample of women: the Women's Cardiovascular Health Network Project Introduction and Methodology. Women & Health 2002, 36(2):1-15.
• [10]Marmot M: The Marmot Review. Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England post 2010. Department of Health, London; 2010.
• [11]Foster C, Hillsdon M, Thorogood M: Interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2005, (1):CD003180.
• [12]Yancey AK, Ory MG, Davis SM: Dissemination of physical activity promotion interventions in underserved populations. American Journal of Preventive Medicine 2006, 31(4S):S82-S91.
• [13]Dawson J, Boller I, Foster C, Hillsdon M: Evaluation of changes to physical activity amongst people who attend the walking the way to health initiative - prospective survey. The Countryside Agency 2006.
• [14]Eyler AA, Matson-Koffman D, Young DR, Wilcox S, Wilbur J, Thompson JL, Sanderson B, Evenson KR: Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: the Women's Cardiovascular Health Network Project summary and conclusions. American Journal of Preventive Medicine 2003, 25(3 Supplement 1):93-103.
• [15]Withall J, Jago R, Fox KR: Why some do but most don't. Barriers and enablers to engaging low-income groups in physical activity programmes: a mixed methods study. BMC Publ Health 2011, 11(507):1-13.
• [16]Withall J, Jago R, Fox KR: Who attends physical activity programmes in deprived neighbourhoods? Heal Educ J 2011, 70(2):206-216.
• [17]Allender S, Cowburn G, Foster C: Understanding participation in sport and physical activity among children and adults: a review of qualitative studies. Health Educ Res 2006, 21(6):826-835.
• [18]Biddle S, Mutrie N: Psychology of physical activity: Determinants, well-being, and interventions. Routledge, Oxford; 2008.
• [19]King AC, Jeffery RW, Fridinger F, Dusenbury L, Provence S, Hedlund SA, Spangler K: Environmental and policy approaches to cardiovascular disease prevention through physical activity: Issues and opportunities. Heal Educ Q 1995, 22:499-511.
• [20]Trost SG, Owen N, Bauman AE, Sallis JF, Brown W: Correlates of adults' participation in physical activity: review and update. Medicine & Science in Sports & Exercise 2002, 34(12):1996-2001.
• [21]UyBico SJ, Pavel S, Gross CP: Recruiting vulnerable populations into research: a systematic review of recruitment interventions . Journal of General Internal Medicine 2007, 22(6):852-863.
• [22]Mutrie N, Foster C, Estabrooks P, Burton NW, Baker G: Recruiting hard-to-reach populations to physical activity studies: evidence and experiences. J Phys Act Heal 2010, 7(Supple):329-331.
• [23]Department of Health: HIP, Social Marketing and Health Related Behaviour: Ambitions for health. Department of Health, London; 2008.
• [24]Department of Health: Changing Behaviour, Improving Outcomes: A new social marketing strategy for public health. Department of Health, London; 2011.
• [25]Stead M, Hastings G, McDermott L: The meaning, effectiveness and future of social marketing. Obes Rev 2007, 8(s1):189-193.
• [26]Andreasen AR: Social marketing: its definition and domain. Journal of Public Policy & Marketing 1994, 13(1):110.
• [27]Des Jarlais DC, Lyles C, Crepaz N: The TG: improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The tREND statement. Am J Public Health 2004, 94(3):361-366.
• [28]UK Life expectancy. http://www.nhs.uk/news/2011/03March/Pages/uk-life-expectancy-still-rising.aspx webcite]
• [29]Noble M, McLennan D, Wilkinson K, Whitworth A, Barnes H, Dibben C: The English Indices of Deprivation. Communities and Local Government, London; 2007:1-129.
• [30]Bristol City Council: Deprivation in Bristol 2007. Bristol City Council, Bristol; 2007.
• [31]Bristol City Council: Promoting health and well-being in Bristol. In The City council’s health strategy 2006–2009. Bristol City Council, Bristol; 2006.
• [32]National Social Marketing Centre Benchmark Criteria. http://www.nsmcentre.org.uk/sites/default/files/benchmark-criteria-090910.pdf webcite
• [33]Kotler P, Roberto N, Lee N: Social Marketing: Improving the quality of life. Sage, Thousand Oaks, California; 2002.
• [34]Hastings G: Social Marketing: Why should the devil have all the best tunes?. Elsevier, Oxford; 2007.
• [35]Eyler AE, Wilcox S, Matson-Koffman D, Evenson KR, Sanderson B, Thompson J, Wilbur J, Rohm-Young D: Correlates of physical activity among women from diverse racial/ethnic groups. Journal of Women's Health & Gender-Based Medicine 2002, 11(3):239-253.
• [36]Froelicher ES, Lorig K: Who cares about recruitment anyway? Patient Education and Counseling 2002, 48(2):97-97.
• [37]Grimshaw J, Campbell M, Eccles M, Steen N: Experimental and quasi-experimental designs for evaluating guideline implementation strategies. Fam Pract 2000, 17(suppl 1):S11-S16.
• [38]Christopoulos A, Reynolds L: Evaluating social marketing: Lessons from ShowCase. Perspectives in Public Health 2009, 129(6):272-276.
• [39]Helmig B, Thaler J: On the effectiveness of social marketing - what do we really know? Journal of Nonprofit & Public Sector Marketing 2011, 22(4):264-287.
• [40]Neighbourhood Partnership Statistics. http://bristolpartnership.org/neighbourhood-partnerships webcite
• [41]Buttle FA: Word of mouth: understanding and managing referral marketing. J Strateg Mark 1998, 6(3):241-254.
• [42]Anderson EW: Customer satisfaction and word of mouth. J Serv Res 1998, 1(1):5-17.
• [43]Czepiel JA: Word-of-mouth processes in the diffusion of a major technological innovation. J Mark Res 1974, 11(2):172-180.
• [44]Oliver RL: Satisfaction. McGraw Hill, Singapore; 1997.
• [45]Hu N, Pavlou PA, Zhang J: Why do Online Product Reviews have a J-shaped Distribution?. Overcoming Biases in Online Word-of-Mouth, Communication; 2007.
• [46]Cavill N: National campaigns to promote physical activity: can they make a difference? International Journal of Obesity and Related Metabolic Disorders 1999, 22:48-51.
• [47]Lowther M, Mutrie N, Scott EM: Promoting physical activity in a socially and economically deprived community: a 12 month randomized control trial of fitness assessment and exercise consultation. Journal of Sports Sciences 2002, 20(7):577-588.
• [48]A guide to typical response rates. http://www.royalmail.com/portal/rm/content1?mediaId=600089&catId=400098 webcite
• [49]Response Rate Trend Report [. 2010. [ http://www.the-dma.org/cgi/dispannouncements article=1451 webcite]
• [50]Fitness Industry Association: Winning the retention battle; Reviewing key issues of UK health & fitness club membership retention. Fitness Industry Association, London; 2001.
• [51]Williams NH, Hendry M, France B, Lewis R, Wilkinson C: Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review. Br J Gen Pract 2007, 57(545):979-986.
• [52]Dishman R: Exercise adherence: Its impact on public health. Human Kinetics, Champaign, IL; 1988.
• [53]Silva M, Markland D, Minderico C, Vieira P, Castro M, Coutinho S, Santos T, Matos M, Sardinha L, Teixeira P: A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: rationale and intervention description. BMC Publ Health 2008, 8(1):234. BioMed Central Full Text
• [54]Thogersen-Ntoumani C, Ntoumanis N: The role of self-determined motivation in the understanding of exercise-related behaviours, cognitions and physical self-evaluations. J Sports Sci 2006, 24:393-404.
• [55]Ryan R, Frederick C, Lepes D, Rubio N, Sheldon K: Intrinsic Motivation and Exercise Adherence. Int J Psychol 1997, 28:335-354.