Guide to Conducting a Health Communication Campaign to



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Buenos Dias, Arthritis
(Good Morning Arthritis)

~
Guide to Conducting a Health Communication Campaign to

Reduce the Burden of Arthritis in the Hispanic Population




~
Presented by:

Centers for Disease Control and Prevention

September 29, 2006 – September 2011

DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Services


Centers for Disease Control and

Prevention (CDC)

Atlanta, GA 30314-3724

Dear Colleague: September 29, 2006

I am pleased to introduce Buenos Dias, Artritis, a campaign to promote physical activity as a method of arthritis self-management for the Spanish-speaking Hispanic population between the ages of 45 and 64.


Research shows that although the prevalence of arthritis among the Hispanic population is less than that experienced by whites, higher proportions of Hispanics report work limitations due to arthritis and severe joint pain.
As you know, physical activity can have an important and beneficial effect on arthritis pain and associated disability. Working together, state arthritis programs and their partners, along with the Centers for Disease Control and Prevention aim to encourage audience members to begin or increase participation in moderate exercise. The campaign promotion materials are designed to:


  • Raise awareness of physical activity as a way to manage arthritis pain and increase function

  • Increase understanding of how to use physical activity (types and duration) to ease arthritis symptoms and prevent further disability

  • Enhance the confidence or belief of persons with arthritis that they can be physically active

  • Increase trial of physical activity behaviors

The CDC has developed the information in this package to assist you in disseminating the campaign. From September 2005– January 2006, the materials were pilot tested by five state health departments, and information regarding their experiences has been included to improve your results. You will find the following within the guide:


  • Tools to help you plan your campaign, including an audience profile

  • Information about placing public service announcements (PSAs) and buying radio airtime or print space

  • Specifications and technical information for localizing and reproducing print materials and radio advertisements

  • Suggestions for partnering with local Hispanic organizations that can help spread the message

  • An abbreviated Implementation Guide to assist your implementation partners

  • Compact disks (CDs) containing master copies of radio spots, print creative and both guides

I hope these materials will be useful to you in reaching the Spanish-speaking Hispanic audience with arthritis.


Sincerely,

Teresa J. Brady, Ph.D.

Senior Behavioral Scientist

Arthritis Program


Table of Contents
I. Background and Implementation Information Page


  • Campaign Overview and Planning 5

  • The Role of Communication and Media Relations Tools 9

  • Demographic Information and Media Habits

of the Hispanic Population 10

  • Suggested Implementation Timeline 12

  • Ensuring PSA and Advertising Placement Effectiveness 13

  • Identifying Community Partnerships & Opportunities 17



II. Sample Campaign Materials Page





  • Campaign Overview* 27

  • Target Audience Profile 30

  • Print Creative Materials* 33

  • Radio Creative Materials* 56

  • Printing and Reproduction Specifications 65


III. Additional Resources Page



68

74

77



79

81

83



87

91

92



96

102


109

112
113





  • Appendix A - Implementation Planning Worksheet*

  • Appendix B - Sample Pitch Letter for Public Service Director*

  • Appendix C - Sample Letter: Response to Public Inquiries*

  • Appendix D - Sample Thank You Letter for Post Meeting*

  • Appendix E - Sample Thank You Letter after Media Runs PSA*

  • Appendix F - Newsletter Article*

  • Appendix G - Resources Fact Sheet*

  • Appendix H - Tracking Form

  • Appendix I - Template Web Site Copy*

  • Appendix J - Hispanic Population by Largest U.S. Cities

  • Appendix K - Density of Hispanic Population by U.S. City

  • Appendix L - Frequently Asked Questions

  • Appendix M - Campaign Feedback Form


IV. Step-by-Step Partner Implementation Guide


  • This version is for your information only. The entire Step-by-Step Implementation Guide, complete with sample creative and additional resources is contained in the Partner Guide file on Disk 1. You can easily print it, or e-mail it to partners from the Partner Guide file on Disk 1.


*Marked items are available in English and Spanish

Section 1

Background and Implementation Information


Campaign Overview and Planning
The Hispanic population is growing at a rate of 1.7% per year, making them the nation’s largest minority population. In fact, the U.S. population now has more than 39.8 million Hispanics, and by 2050 the Hispanic population will comprise approximately one-quarter of the U.S. population.
Unfortunately, arthritis imposes a serious economic, social and psychological threat to the Hispanic population. In total, 2.6 million Hispanics have arthritis.
According to the February 11, 2005 Morbidity and Mortality Weekly Report (MMWR), although Hispanics have a lower prevalence of doctor-diagnosed arthritis than whites (21.9% versus 15.8%), more Hispanics report severe joint pain, compared to whites (32.5% versus 22.6%). In addition, Hispanic people with arthritis, when compared to white people with arthritis, report similar rates of activity limitation attributable to arthritis (39.7% versus 34.1%) but a higher rate of arthritis attributable work limitations (38.8% vs. 28%).
As you know, physical activity or exercise can have a beneficial effect on arthritis; yet, many within the target population do not engage in moderate exercise as a way to manage their arthritis. Therefore, the goal of this campaign is to encourage the target audience to begin or improve management of their arthritis by beginning or increasing participation in moderate exercise.
NOTE: While the general campaign used the phrase “physical activity,” research conducted for Buenos Dias, Artritis determined that the term “exercise” is more motivating to this target audience.
Objective of this Guide:

This guide was designed to provide the following:



  • Background information on target audience and the campaign’s development

  • Recommendations and suggestions on implementing the campaign

  • Supplemental materials, such as pitch letters, newsletter articles, etc. to help you implement the campaign


Target Audience:

The primary audience for this campaign is lower socio-economic status (SES) segments (income under $35,000) within the Hispanic population, who are Spanish speaking, ages 45-64, with doctor-diagnosed arthritis, or possible arthritis, which threatens to affect valued life roles.


Target Demographic Areas:

This guide is specifically designed for the 36 state health departments that receive Centers for Disease Control and Prevention funding for arthritis and their partners that work with them to implement health communication activities. Other organizations are welcome to use the campaign as well (see Section IV for the Step-by-Step Partner Implementation Guide).


Key Messages From the Campaign:

Overarching messages to be communicated to Hispanic/Latino populations are similar to those of CDC’s general arthritis campaign, launched in 2002:




  • Exercise can help persons with arthritis do something themselves to improve their arthritis symptoms.




  • Moderate exercise has important and beneficial effects on arthritis pain and associated disability. Studies show that 30 minutes of moderate exercise, at least three days per week can help relieve arthritis pain and stiffness and help persons with arthritis be more active and feel more energetic and positive. The 30 minutes of exercise per day can be done in three 10-minute increments throughout the day.




  • Walking, swimming, and biking are particularly good activities for people with arthritis.


Campaign Elements:

The Buenos Dias, Artritis campaign consists of taped radio spots and live-announcer scripts, a brochure and sticker to be placed as a counter top display, and print advertisements including outdoor billboards, bus shelter placards, flyers, bill stuffers, and bookmarks. All radio and print executions can also be used as either a PSA or a paid placement.


To conduct the campaign, it is necessary to use, at a minimum, the following Spanish campaign materials: brochures distributed in community locations, and either the radio spots, bus shelter placards, or outdoor billboards. Print ads, flyers, bill stuffers, and bookmarks are all useful additions to the core campaign elements.

Quick Tip
Above, we mention four different ways to use the print creative provided, including print ad, flyer, bill stuffer, and bookmark. Each of these pieces also can be used as an advertisement or a PSA so, you can also think of it as having four different sizes available to support your campaign goals.

All campaign materials are in Spanish; however, select English translations have been provided to support local clearance requirements, as well as to provide additional options for those situations when you want to supplement the Spanish campaign with a few English placements (as our target audience does consume some English media).


Campaign elements were designed with feedback from you on the Physical Activity. The Arthritis Pain Reliever. campaign. For this reason, you will receive a CD ROM package, as well as find materials posted on the CDC web site at http://www.cdc.gov/arthritis.
Creative materials are provided in both hard copy (within this guide), as well as on CD ROM. The information below outlines the variety of materials provided to support this campaign. Please refer to Section II – Sample Campaign Materials, Printing and Reproduction Specifications.

IMPORTANT NOTE
All radio and print materials may be aired/placed from September 2006 through September 1, 2011. Campaign materials expire after September 1, 2011 making it illegal to use the creative materials after this date.


Print Materials:

  1. 7 x 10 (print advertising)

  2. 8.5 x 11 (flyer)

  3. 5.25 x 3.25 (bill stuffer)

  4. 2.25 x 6 (bookmark)

  5. 19’ x 48’ (outdoor billboard)*

  6. 4’ x 6’ (bus shelter placard)**

There are four different visuals for the first four creative executions listed above, including:



  • Couple walking outdoors

  • Couple walking indoors (mall)

  • Man walking dog

  • Group of women walking

*The billboard execution uses two visuals: group of women walking and couple walking outdoors

**The bus shelter placard execution uses only one visual: couple walking outside.
Each of the above is provided in color and black and white versions. The national versions are provided in PDF format. These versions are “locked” and cannot be modified. The national format uses the Arthritis Foundation toll-free number and Spanish web site as the response mechanism. The localizable versions are provided in Quark and can be adapted, by a designer with access to this program, to include a local program logo, as well as a local phone number or web site (you would replace the Arthritis Foundation contact information). In addition, Quark allows each of the creative elements to be re-sized, providing you limitless options in meeting any media outlet’s specifications.
When selecting which visuals to use, it is important to note that testing revealed that the target audience was most attracted to these materials because they were in Spanish, had “arthritis” in the title, and were colorful. You do not need to be concerned if the graphics do not look just like the Hispanic population you are targeting.
Most target audience members did perceive the individuals depicted in the campaign graphics as Hispanic, and like themselves or people they knew. However, the specific appearance of the people depicted did not influence whether or not an individual was attracted to the campaign material. In addition, the type of dog pictured in the graphic of the man walking a dog was irrelevant to the target audience.
Brochure:

A three-panel brochure is provided for distribution in your market. See Identifying Community Partners & Opportunities for ideas on where to distribute your brochures. In addition, a sticker has been designed to use on a brochure holder. There is no specified brochure holder; you select the style that best suits your needs. For example, you can order brochure holders from Screen Art Posters, Inc., 4333 East 10th Lane, Hialeah, FL 33013 (305-681-4641). BRO-HOLD model # A414-112 has worked well in past campaigns.





Quick Tip
Several states found that an effective use of the brochure is in arenas where personal contact with the target audience is possible. For example, the California Arthritis Program distributed brochures to community clinics in Hispanic areas. Uptake of the brochures was high and clinics called to receive additional brochures. Social service centers, local farmers markets, and community events targeting the Hispanic population were also identified as good locations.
The Oklahoma Arthritis Program posted flyers above the brochure rack at community locations to ensure longevity of the campaign messaging if/when the brochure supply became depleted.




Radio Creative:

The following radio creative is provided for your use. Please use the unique code that identifies each spot when working with a radio station.




  1. :60-second taped radio spot (HART-0560)

  2. :50/:10-second taped radio spot with ability to add :10 second local tag (HART-0550)

  3. :30-second taped radio spot (HART-0530)

  4. :25/:05-second taped radio spot with ability to add :05 second local tag (HART-0525)

  5. :30-second live announcer script (to be read by on-air personality, not pre-recorded)

  6. :25/:05-second live announcer script (to be read by on-air personality, not pre-recorded


When to Run Your Campaign:

Besides National Arthritis Month in May, you also may want to keep in mind the following:




  • Seasons: Think about activating the campaign at times when campaign messages will be most relevant -- such as spring through fall, when people are most inclined to get active outside

  • Timing: Consider other community activities to tag on to and competing activities to avoid

  • Special Months: Consider focusing efforts around Hispanic Heritage Month (usually runs September 15 – October 15 of each year) when media outlets already may have promotions planned

  • Community Celebration Days: September 15 marks Independence Day for Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua; September 16 is Mexican Independence Day; and El Dia de la Raza is celebrated October 12

  • Partner Activities: Try to have your efforts coincide with a partner’s media or event activities


See Identifying Community Partners & Opportunities for ideas on different local organizations to partner with, including Hispanic organizations.
Important Note
Health department or arthritis coalition names and/or logos can be added to the materials. The addition of other logos will require approval of the CDC Technology Transfer Office. This approval can take several months to receive. See Section III – Additional Resources, Appendix L for Frequently Asked Questions.


The Role of Communication and Media Relations Tools
In today’s competitive public service announcement (PSA) world, it isn’t enough to just send a PSA to a media outlet or partner organization and hope for the best. You must consider the entire news angle, convince them of why the issue is important, develop a communication package and strategy, and be prepared to follow up with them.
To garner media attention about the campaign and the issue overall (prevalence of arthritis and disparity within the Hispanic community), consider the following ideas to help strengthen your approach:


  • Find a local Spanish-speaking rheumatologist or general practitioner (ideally one who has a large Hispanic patient volume) to act as a spokesperson for the campaign

  • Ask a person with arthritis who is Hispanic to hand-deliver the materials to the station with you or for you. This creates a very personal element and allows a member of the target audience to reiterate the importance of the campaign

  • Refer to the Appendix to create a full media kit and consider including information such as the most recent MMWR on arthritis (Racial/Ethnic Differences in the Prevalence and Impact of Doctor-Diagnosed Arthritis --- United States, 2002; February 11, 2005), which is a credible resource for the media

  • Pitch stories to local radio stations, television stations and newspapers to interview key arthritis experts or run feature stories about the benefits of exercise in managing arthritis

  • If you do receive confirmation that a story will run, ask if you can get space/air time to run the campaign creative within or next to the story or air the radio spot immediately after the story runs



Quick Tip
Once a media outlet shows interest in how arthritis affects the Hispanic population, now is the time to also ask if they are willing to place/air the creative for several weeks.


Communication and Media Materials to Support Your Goals:

Within the Appendix, you will find several materials to support your communication and, potentially, your media relations goals. Please refer to Section III – Additional Resources for the following materials:


  • Sample Pitch Letter for Public Service Director, Appendix B

  • Newsletter Article Template, Appendix F

  • Post-Meeting Sample Thank You Letter , Appendix D

  • Sample Thank You Letter after Media Runs PSA, Appendix E

  • Template Web site copy, Appendix I



Demographic Information and Media Habits of the Hispanic Population
Chart Outlining Population Information for Each City/State:

To assist in targeting efforts within each state, Appendix J provides information on the prevalence of the Hispanic population in major cities in the state. Appendix K lists those cities in the state with the highest percentage of Hispanic population. With limited dollars and time, these may help prioritize which cities to target.



Quick Tip
The Florida and California Arthritis Programs found it helpful to use census data to determine the geographical location of their target audience. The California Arthritis Coordinator recommends that other states do this because the target population was ‘not where I thought they were”. If time and budget permit, you may find it helpful to use census tracts too. Visit http://www.census.gov/ for more information.




Customizing Your Media Materials:

To assist you in customizing your media materials, state-specific estimates can be found at http://www.cdc.gov/arthritis/data_statistics/state_data.htm. Here, you can search for the total number of adults in your state living with arthritis and identify what percentage of the adult population are Hispanic. This information is taken from The Behavioral Risk Factor Surveillance System (BRFSS), a state-based survey of the U.S. population aged 18 years or older.
Media Habits of the Hispanic Population:

The following information provides an overview of media habits for people of Hispanic origin, not necessarily Spanish speaking and not specifically for people with arthritis. The data includes both men and women between the ages of 35-54 and 55+. The research should help you to determine how best to reach out to your target population.




  • The older Hispanic population has a variety of media habits that flow back and forth from Spanish to English, so a varied media strategy is best.




  • Highest usage of newspapers is by Hispanic males 55+ who are more likely to mix their media exposure between Spanish and English media. Hispanic men in this age group spend the least number of their media hours with radio.




  • Hispanic women age 55+ spend more time with media than Caucasian or African American women, and Hispanic females are more partial to Spanish media than are Hispanic men. Hispanic women in this age range spend the majority of their time with television and radio; however, they still maintain a varied media habit switching between English and Spanish.




  • Hispanic women between 35-54 spend twice as much time listening to Spanish radio than English radio. This group’s next highest category of information consumption is magazines; they spend the same amount of time with English magazines as they do with Spanish magazines.




  • Hispanic men between 35-54 also spend more time with Spanish radio than English. This group’s next highest area of consumption is newspapers, where they spend a little more time with English papers than Spanish papers.

*Synovate: 2004 U.S. Hispanic Market Report


Prioritizing Your Time and Potentially Your Money:

Consider the last two sections above, as well as the demographic information in Appendices J and K, as you consider which cities and which media outlets to place your efforts.



Suggested Implementation Timeline
Below is a suggested timeline and checklist, which shows each step of the campaign implementation process. Because resources vary, we have included a variety of ideas to consider. Please identify and implement the steps that are ideal for your organization.
Month One:

  • Print Buenos Dias, Artritis How-To Guide

  • Review contents to become familiar with campaign goals, content of the guide, and resources

  • Conduct a brainstorming session with your team to determine the best implementation process, local organizations to partner with and ideal timing for your state


Month Two:

  • Develop your contact list (public service directors for PSAs; advertising personnel for paid placement; healthcare reporters if you choose to create a larger story with the media)

  • Schedule in-person meetings with key PSA Directors or reporters; identify members of the Hispanic population with arthritis to attend meetings with you, a member of one of the organizations you are partnering with or a rheumatologist

  • Customize enclosed template media materials for both in-person meetings and mailings (see Section III – Additional Resources for a variety of media outreach materials)

  • Determine appropriate distribution method for materials (hard copy, CD ROM, or e-mail)

  • Create custom kits for each contact/media outlet

  • Distribute kits to media targets (consider personally delivering kits), and/or finalize list of outlets to receive paid placements


Month Three:

  • Follow up with media you meet or talk to within 48 hours. If you spoke to someone on the phone or in person, send a follow-up thank you letter (see Section III - Appendix D).

  • Follow up with all other contacts, within two weeks, by placing a phone call to assess interest and determine if additional information is needed


Continuous Follow-Up Steps:

  • Send thank you letters to all outlets that do run the PSA campaign. Ideally, ask multiple individuals from your organization, partner organizations, and people with arthritis to send a thank you letter to show the depth and breath of your thanks and to encourage the media outlet to continue running the campaign

  • Follow up with media who have yet to run the campaign to determine if there are any additional options (select ideal times of the year, such as the following: National Arthritis Month, New Year’s (resolution time), spring, summer or fall (active outdoor seasons), a special event, etc.


Tracking Your Placements:

It’s important not only to garner a placement of your PSA and/or an article, but also to track which outlets, contacts, and target audience you reached (see Section III – Additional Resources, Appendix H for a sample tracking form). Use a separate tracking form for each outlet and if you receive multiple placements, consider attaching a blank chart to continue monitoring the campaign’s progress.





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