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Application to the Delta Omega Scholarship
Practice Project
Anna Kharmats
What about peers and parents? Involving children and their caregivers in
communication material development for an obesity prevention social marketing
Introduction and Aims.
Prior research in low-income communities in Baltimore shows that children frequently obtain
high-calorie, low-nutrient food from corner stores and carryouts, and the availability of healthier
options is limited (Dennisuk et al., 2011). This pattern of dietary intake is a risk factor for negative
physical and psychological outcomes (Daniels, 2006; Thompson et al., 2007) which disproportionately
effect African Americans (AA). The Baltimore Healthy Communities for Kids intervention (BHCK)
has been initiated to address the food environment through policy changes and subsidies for healthier
food items to wholesalers and corner stores. However, increasing access to and reducing prices of
healthier options does not guarantee that people will buy the promoted items. Specific social
marketing campaign strategies need to be developed and tested to pick culturally appropriate
communication materials (CMs) that would help increase demand for the promoted products among
AA children ages 10-14 and their caregivers, and reduce health disparities associated with dietary
I am proposing to conduct a sub-study, which is not part of original research plan or budget,
with the aims of: (1) facilitating the development of effective and theory-based messages and
strategies that will be appealing to the target audience, easy to understand, attention grabbing, relevant,
and readable, and (2) investigating the feasibility and appeal of adding a periodic text-messaging
component to the intervention by obtaining feedback from parents. Of particular interest to me is the
finding from formative research for BHCK that children stated that their food choices are influenced
more by their parents, whereas parents expressed that their children’s food choices were influences
more by peers. Evidence in the literature that suggests that both of these observations could be valid.
Prior studies show that children view parental involvement in their everyday decision making as less
legitimate as they get older, and instead children’s decisions become increasingly based on
interactions with their peers; this change occurs earlier for boys (Kuhn & Laird, 2011). On the other
hand, purchasing of healthier food items among girls was found to be associated with the
characteristics of adult caretakers (Surkan, 2011). The communication materials (CMs) used for the
social marketing campaign will need to account for these findings, and address both peers’ and
caregivers’ influences on children’s food choices. The child audience might need to be segmented
based on age and gender.
Methods and Outcomes.
There will be four phases of material development. The first two phases will be part of preproduction, and the last two phases will be part of the production stage.
Application to the Delta Omega Scholarship
Practice Project
Anna Kharmats
Phase One. The research team will identify existing materials, extract themes from prior
formative research that could be used to create CMs, and make suggestions for additional materials
that need to be created. The team will work from the Social Cognitive and Social Learning Theory
perspectives, and draft materials that address both peer and parental influences on children’s food
Phase Two. One focus group with parents and two focus groups with children will be
conducted to solicit feedback. The goals are to identify messages which best resonate with the focus
group members and would motivate behavior change, to generate ideas about additional themes to be
explored, and to learn more about participants views on receiving text-messages relating to sales of
promoted foods in their communities.
Phase Three. Community partners such as young artists from New Lens, and graphic designers
will further develop the materials and make them more visually appealing.
Phase Four. Another round of groups will be conducted to test whether the materials are easy
to understand, resonate well with the target audiences, convey the intended messages, and are visually
appealing. Final edits will be made and the developed materials will be used for the BHCK
intervention. Posters and handouts will be distributed at corner stores, carryouts, recreation centers,
and community events.
Ultimately the outcome of interest is to determine how effective these communication
strategies are in terms of increasing purchasing and consumption of healthier food, and decreasing
BMI among AA children ages 10-14. The evaluation component is already part of the BHCK grant
and will include measures of dietary intake, food purchases, and anthropometry which will be
collected prior to participants’ enrollment in the BHCK intervention and post-intervention. These
outcomes will be compared among participants who received CMs verses those who did not. The dose
of CMs received and reach of CMs will also be evaluated. Additional comparisons will be made
among those who received different types of CMs (i.e. CMs that focus on peers, parents, or neither).
This will be the first study among low-income AA children and their parents to develop and
test CMs that account for peer’s and caregiver’s influences on children’s food choices, segment the
audience based on children’s ages and gender, and involve parents and community members in
multiple stages of material development. The findings of this research could potentially change the
communication strategies used to reach AA families about nutritional choices. Currently, much of
nutritional communication focuses on numbers, calories, dietary guidelines, and individual choices.
Instead focusing on the larger context in which food choices occur, such as during meals with parents
at home, and trips to the corner store with peers, could be a more effective way to motivate behavior
Application to the Delta Omega Scholarship
Practice Project
Anna Kharmats
Allocation of expenses
Total expenses asked to be covered by the Delta Omega Scholarship = $1,000
• $20 (gift cards per participant) * [14 ( 7 adult participants per 2 focus groups) + 24 (6 child
participants per 4 group)] = $ 760
• $40 (per hour for focus group facilitator) * 6 (focus groups) * 1 hour = $ 270
Additional expenses that I will apply for through other funding opportunities (i.e. Urban Health
• Transportation to focus groups = $ 60
• $15 (per one hour of transcription & checking) * 6 (transcripts) * 10 (hours per transcript) =
• $30 (per hour for focus group note taker) * 6 (focus groups) * 1 hour = $ 180
• $15 (per hour for focus group guide preparation) * 6 groups * 3 hours = $ 270
*** The work is part of a larger BHCK intervention that is supported by grants from the NIH, the
Abell Foundation, the Robert Wood Johnson Foundation, the Urban Health Institute (for a different
component of the project), Urbanite, and other agencies. However, conducting focus groups with
children and parents to test communication materials and strategies was not part of the original budget.
I plan to focus my dissertation on this topic.