Plansbook for Campaigns

BILL 51
2011
Kansas Department of
Health and Environment
Plans Book
Portion Control to reduce Tween Obesity in
Douglas County

Kansas Department of Health and Environment Plans Book 2011
[ T a k e P o r t i o n C o n t r o l ]

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Presented by


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Meet the team:

Jena Comiskey Hometown: Shawnee Mission
Position: Research Director
Specialty: Analyzing data

Meghan Crylen Hometown: St. Louis
Position: Account Executive
Specialty: Copy writing

Hannah Gillaspie    Hometown: Leawood
Position: Media Planner
Specialty: Media Relations

Joseph Kearney   Hometown: Overland Park
Position: Media Relations
Specialty: Interactive

Hannah Kincaid Hometown: Overland Park
Position: Event Coordinator
Specialty: Community Outreach

Lindsay McNeese   Hometown: Olathe
Position: Creative Director
Specialty: Print  Design

*Why Bill 51? Our team members were born between 1988 and 1989. We
came together under unconventional circumstances to start an Ad agency, and
immediately realized we had a shared characteristic: wit. So what is Bill 51?
Reverse it and you have the approximate population of the world when the six
of us entered it: 5.1 billion. Currently, the population of the world is 6.7
billion, but we found each other, fused our talents, and are still standing out.


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Executive Summary
The Problem
Through primary and secondary research, KDHE found that obesity is a problem amongst
tweens in Douglas County, Kansas. Through further research we were able to attribute this
problem to the following factors:
 Lack of knowledge about healthy portion sizes among tweens and their parents.
 Lack of portion control among tweens and their parents
 Misperceptions about what constitutes a healthy body weight.
Our Goal
Decrease tween obesity in Douglas County by 5 percent through tween and parent
education of healthy portion sizes.
Our Campaign
In order to decrease tween obesity in Douglas County, Bill 51 Inc. recommends that KDHE
implements the following strategic plan to increase parent and tween knowledge of portion
control:
 Increase the knowledge of portion control as a contributing factor to tween
obesity among parents in Douglas County from third place to second. The first
objective of our strategic campaign is to drive parents of tweens to the KDHE “Take
Portion Control” parent website. The plan is to utilize banners, print
advertisements, informational pamphlets and public transportation advertisements
to increase website traffic. Once on the website, they can gain tips and information
about portion control as well as about local events.
 Increase awareness of portion control and educate tweens in Douglas County
that it is a main contributing factor to tween obesity. The second objective
produces a radio ad with Conner Teahan. He has agreed to consider representing
the campaign on a voluntary basis. Strategically placed interactive pamphlets and
placemats at local restaurants will involve tweens in their own education about
portion control.
 Engage 15 percent of parents and tweens in Douglas County in interactive
education about portion control. This objective is meant to encourage the parents
and tweens of Douglas County to implement healthy food portions into their daily
lifestyles by providing community learning opportunities.
Ultimately, this campaign will be considered successful if KDHE finds evidence supporting a
decrease in tween obesity in Douglas County.


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7‐ Figures and Tables
10‐ Situation Analysis
60‐ S.W.O.T. Analysis
65‐ Strategic Plan
68‐ Creative Plan
105‐ Media Plan
118‐ Timeline
145‐ Budget
147‐ Evaluation
150‐ References


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Figures and Tables
Figure 0: KDHE flow chart (12)
Figure 1: Governor Sam Brownback (13)
Figure 2: There are many fun and easy ways to remember the correct portion size for a
child (16)
Figure 3: A healthy diet includes a balance of each category from the food pyramid, even
the occasional sweets! (16)
Figure 4: Obese children are more likely to become obese adults, a status that leads to
increased risks of diabetes and stroke. (17)
Figure 5: The average tween spends approximately 7 hours online a week. (19)
Figure 6: Many Parents report that their children crave sweets and are picky eaters (22)
Figure 7: Many companies advertising unhealthy food have created playful characters to
catch children’s eye, like these created by McDonalds. (24)
Figure 8: The price of healthy foods has been on the rise, while unhealthy foods such as
chips and packaged goods are experiencing a decline in price. (26)
Figure 9: Taking the bus to school is becoming more popular than walking for modern
children. (29)
Figure 10: Physical Education is an ideal time to teach children about healthy lifestyle
choices and eating habits. (32)
Figure 11: McDonalds logo (35)
Figure 12: Burger King logo (37)
Figure 13: Wendy’s logo (39)
Table 1: Parent income (41, 42)
Figure 14: Cereals that market to tweens contain bright colors, funny characters, and are
placed lower to the ground within a child’s line of sight. (43)
Figure 15: Pepperidge Farm goldfish use playful games and colors to appeal to children"
(44)
Figure 16: Kraft targets children with creative and fun noodle shapes (44)
Figure 17: Campaign for tobacco free kids (45)
Figure 18: Putting cigarette out (46)
Figure 19: Dare logo (47)
Figure 20: Students against violence everywhere (48)
Figure 21: Parent Income (50)
Figure 22: How often parents cook at home (51)
Figure 23: Mother and daughter reading (52)
Figure 24: snacking and income (54)
Figure 25: family dining out (55)
Figure 26: Commercials that tweens like the most (56)


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Figure 27: Marketers target tweens by using friendly cartoon charecters (57)
Figure 28: Does your tween fall within a healthy BMI range for his/her age? (59)
Figure 29: Conner Teahan banner (69)
Figure 30: billboard 1 my food portions should be this big (71)
Figure 31: Tween obesity is an adult‐sized problem (72)
Figure 32: Tween gluttony leads to a lifetime of obesity (73)
Figure 33: Parent brochure (75)
Figure 34: Tween brochure (76)
Figure 35: tote bag (77)
Figure 36: magnet (78)
Figure 37: Pens (79)
Figure 38: Frisbee (80)
Figure 39: baseball (81)
Figure 40: cards (82)
Figure 41: crayons (83)
Figure 42: placemat (85)
Figure 43: Print ad 1 (87)
Figure 48: Game ad (92)
Figure 49: Web ad 1 (98)
Figure 53: Web site‐ Parent (103)
Figure 54: Web site‐ Tween (104)


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Big Food.  Big Problem.

The prevalence of childhood obesity is continually rising.  In order to combat
childhood obesity, parents and their tweens along with advertisers, restaurants, and
grocery stores, need to recognize one of the main contributors to the problem: portion size.
A portion is something that can be controlled either by the consumer or the server of the
food.  In order to maintain a healthier tween population, our client needs to reduce portion
sizes and the caloric intake of tweens. These small, but important changes could also
reduce the risk of Type 2 diabetes, cardiovascular disease, high blood pressure and high
cholesterol, which are closely linked to obesity.  A study published in September 2010
found that $147 billion is spent annually on healthcare related to obesity in the United
States.  That is an estimated 10 percent of all health costs (Thepharmaletter.com).
Goal
To reduce caloric intake by influencing tweens to consume healthier portion sizes.
What is KDHE?
Mission Statement

The Kansas Department of Health and Environment aims at protecting the health
and environment of the citizens of Kansas (KDHE, 2010).


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KDHE at a Glance

KDHE Accomplishments 2010
The Indoor Clean Air Act
 Required businesses and restaurants to be smoke‐free by July 1 (KDHE, 2010).
Lexie’s Law
 Requires child caretakers to be high school graduates or have an equivalent degree
in order to obtain a child care facility license.
KDHE 2011 Annual Report

Figure 0


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Governor Sam Brownback
 Beginning on July 1, 2011, all child‐care facilities must be inspected at least once
every 12 months (KDHE, 2010).
The Bureau of Epidemiology and Public Health Informatics
 Established in October 2010.
 Collects, analyzes and interprets a broad range of
health‐related data, in a cohesive and integrated
manner (KDHE, 2010).
The Flint Hills Smoke Management Plan (SMP)
 Aims to reduce air pollution from agricultural burning (KDHE, 2010).
In the News
The Kansas Department of Health and Environment partnered with the Centers for
Disease Control to co‐fund a program for the Chronic Disease Risk and Reduction (CDRR).
The goal of this program is to place responsibility on each individual to help reduce health
care costs in Kansas.  The CDRR aims at providing education about chronic diseases to the
citizens of Kansas (Miller, 2011).  The KDHE campaign will call parents and tweens in
Douglas County to learn about what constitutes a healthy portion for tweens and
implement this knowledge into their daily food choices.
Governor Sam Brownback recently combined the Kansas Health Policy Authority
with the Kansas Department of Health and Environment (figure 1).  The move is one of
Figure 1


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many actions taken by Brownback to reorganize Kansas’s government.  Another reason for
the move is to relieve some of the financial burden caused by Medicaid.  Brownback
believes the move will save millions of dollars and help with the $550 million deficit related
to increased caseloads in Medicaid (Milburn, 2011).
Healthy Kansans 2010
Healthy Kansans 2010 is a branch of Healthy People 2010.  It provides preventative
information for Kansas’s health providers, organizations, communities and the state in
order to encourage health‐based improvements in Kansas.  The Kansas Department of
Health and Environment continues to integrate Healthy Kansans 2010 into its efforts to
promote a healthier community (KDHE, 2010).
The Problem
Defining Obesity
Body Mass Index (BMI) is the most widely accepted method for measuring weight
and obesity.  According to the Centers for Disease Control, “BMI is a measure of weight in
relation to height, that is used to determine weight status” (The Centers for Disease
Control, 2009).
According to the Centers for Disease Control, a child is overweight if their BMI is at
or above the 85th percentile and lower than the 95th percentile.  A child is considered obese
if their BMI falls at or above the 95th percentile (The Centers for Disease Control, 2009).


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The change in the BMI definition
The BMI chart was originally invented in 1850 and in 1998 the chart was reconstructed.
The National Institutes of Health re‐established the overweight threshold for BMI from
27.8 to 25 to match international guidelines. This alteration changed the status of 30
million Americans from the "healthy weight" category to the "overweight" category
(Wilson).
Calorie
A calorie is defined as a unit of energy supplied by food (The Centers for Disease
Control, 2011).
Empty Calories
Empty calories contain little to no dietary nutrition.  According to the National
Institutes of Health, “nearly 40 percent of the energy consumed by 2‐ to 15‐year‐olds
comes in the form of “empty” calories.” Half of the empty calories consumed by children
and tweens come from solid fats and added sugars found in soda, fruit drinks, dairy
desserts, grain desserts, pizza and whole milk (Wein, 2010).  The recommended empty
calorie intake for children is between 8 and 20 percent of their total calories consumed
(National Institutes of Health).
Caloric Balance
Caloric balance is achieved when the calories consumed (by food) are balanced by
the calories used (in normal body functions, daily activities, and exercise) (The Centers for


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Disease Control, 2010). A healthy person maintains a balance of calories consumed and
energy expended.
Portion Size Versus Serving Size
 Portion – the amount of food you choose to eat. There is no standard portion size
and no single right or wrong portion size; each depends on the individual. As figure
2 illustrates, there are many fun and easy ways to figure out a child’s portion size.
 Serving – the standard amount provided by the manufacturer that is used to help
give advice regarding how much to eat or to identify how many calories and
nutrients are in a food. The government issued Food pyramid [figure 3] provides the
daily recommended serving for individuals.

A healthy diet includes a balance of each
category from the food pyramid, even the
occasional sweets!
Figure 3
There are many fun and easy ways to remember
the correct portion size for a child
Figure 2


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Childhood Obesity
National
Childhood obesity as a whole has more than tripled in the last 30 years. In the year
2011, there are 12 million obese children and adolescents in the United States.  For
children ages 6 to 11, the obesity rate has risen from about seven percent in 1980 to nearly
20 percent in 2008.  The obesity rate for adolescents ages 12 to 19 has increased from 5
percent in 1980 to 18 percent in
2008 (The Centers for Disease
Control, 2010).
Not only are obese children
more likely to become obese
adults, obesity during childhood
can cause a myriad of other health
problems later in life. As figure 4
illustrates, obese adults have a
higher death rate than any other
group of individuals in the U.S. adult
population.  Obese youth are more
likely to have cardiovascular diseases such as high cholesterol and high blood pressure.
Type 2 diabetes, stroke and several types of cancer are also associated with obesity.
Furthermore, obese children are at a greater risk for bone and joint problems.  Constant
Obese children are more likely to become
obese adults, a status that leads to increased
risks of diabetes and stroke.
Figure 4


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ridicule from peers can also cause poor self‐esteem as well as social and psychological
problems (The Centers for Disease Control, 2010).
Childhood Obesity in Kansas
Kansas is currently ranked 18th for childhood obesity in the United States (F as in
Fat, 2010). In Kansas, 12.6 percent of children ages 10‐17 are obese, meaning that their
BMI is greater than the 95th percentile.  This is a dramatic increase from the 5.8 percent
reported in 2003 (Zips, 2004).
Childhood Obesity in Douglas County
Douglas County is the 4th healthiest county in Kansas, directly after Johnson County,
according to a University of Wisconsin study (Kansas: 2010 Health Outcomes Map). Median
household income of Douglas County: $48,000.
Obesity costs Douglas County $36 million per year.  It is estimated that people who
are obese pay, on average, $1,429 more per year in healthcare than people who are not
obese (Hull, 2011).  This is relevant because children who are obese are 80 percent more
likely to become obese adults, thus the increasing obese tweens in Kansas means more
health costs in the future (www.obesityaction.org, 2011).
Target Audience
Primary #1: Tweens (age 812)
In 2009, the U.S. population of tweens was 20 million.   In 2009 there were
approximately 500,000 5‐ to 17‐year‐olds living in Kansas. Sixteen percent of tweens in


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Kansas are considered obese and Kansas ranks 18th in childhood obesity. Studies have
shown that poverty rates are closely associated with obesity. According to the 2005‐2009
U.S. census, 10 percent of U.S. families live in poverty.  Approximately 14 to 18 percent of
children living in Kansas live in poverty. In Lawrence, 27 percent of individuals live in
poverty.  Even though obesity is a problem for all races, 85 percent of people living in
Douglas County are white (citydata.com). There were approximately 6,800 children ages 8‐
12 in Douglas County in 2009 (US Census Data). If you apply the rate of obese tweens in
Kansas, it is estimated that 1,156 tweens in Douglas County are obese.
Why Target Tweens?
Tweens are an important target population for prevention efforts because their
unhealthy behaviors are malleable and may be less resistant to change than the behaviors
of adults. Research suggests that behavior‐changing interventions should begin prior to
sixth grade (Life’s first Great Crossroad).
The Life of a Tween
During tween years children experience a transition
from having primarily their parents as influencers, to also
having media and friends to influence their viewpoints. The
time adolescents spend watching television are hours not
spent in more energy‐intensive, physically active activities.
Also, television is often associated with snacking.
The average tween spends
approximately 7 hours online a week.
Figure 5


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While a child is in their tween years, friends, media, and popular culture take
precedence in lifestyle choices.  When a child becomes a tween, they are more likely to have
increased time and access to a variety of media outlets (Life’s first Great Crossroad).
According to the Roper report, the top 5 “cool” things for tweens are music, going to the
movies, being smart/video games, electronics and sports.  Tweens spend an average of 12
hours per week watching TV and 7 hours per week online (CDC, 2000).  As figure 5
illustrates, the time adolescents spend watching television and surfing the web are hours
not spent in more energy‐intensive activities. Because tween years are a transitional period
in children’s lives, tweens tend to have a lot of worries. The top three things 11‐to 12‐year‐
olds say they worry about are getting bad grades, their parents separating, and the future.
Of those 11‐to 12‐year‐olds surveyed, 22 percent of them worry about becoming fat (Life’s
first Great Crossroad).
Additionally, tween’s fast food consumption is increasing. From 1999 to 2004 the
number of female adolescents buying fast food at least three times a week increased from
16 to 27 percent. For males, it has increased from 17 to 30 percent (Bauer). “Children are
eating more frequently and obtaining a greater proportion of their nutrient intake from
snacks, soda, and fast food—which are now readily available in schools” (Life’s first Great
Crossroad). If we can correct some of these bad eating habits in tweens, then we can
effectively curb the growing obesity trend.
How to Target Tweens
Although tweens are mainly influenced by the habits of their parents, they are looking
for new ways to be individuals and express themselves. This makes tweens very open to


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new ideas. Tweens are easy to reach and predict because of their high media consumption,
(Life’s first Great Crossroad). TV and the Internet are popular forms of media among
tweens, but research has shown that many tweens also listen to the radio. According to the
Arbitron study, nearly half of tweens find out about new songs by listening to the radio
(Raymond).  This is causing marketers to take a more serious look at radio when trying to
reach tweens.  Tweens are 42 percent more likely to pay attention to online ads and
reference them in their decision‐making process than any other group of consumers.
However, tweens do NOT consciously turn to official Web sites or product reviews in order
to help in the decision‐making process. Tweens are also 34 percent more likely to pay
attention to word‐of‐mouth among peers than any other age group (vincetonsocial.com).
Tweens have also been proven to be loyal customers for a lifetime. Studies show that if a
person is loyal to a brand as a tween, he or she will remain loyal in their later years (Life’s
first Great Crossroad).
Primary #2: Tween Parents
We will also be targeting parents of tweens. Parents of tweens are 30‐to 47 years
old (mean of 38.8 years), 73.3 percent have at least some college education, and their
average income is greater than $30,000 per year (nature.com). According to the last Census
(2010), there are 774,500 people age 35‐to 54‐ living in Kansas.
The Life of a Tween Parent
Approximately 50 percent of parents enjoy playing videogames with their children at
least once per week (ESA reports), and Sixty‐seven percent of American homes own a


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console, and/or use their PC to run entertainment software.  Parents from the baby boomer
generation (born between 1946 and 1964) approach household decision‐making more
collaboratively than parents of previous generations (Myers). Todays children are seen and
heard from, compared to previous generation’s views where children were seen but not
heard from.  Because today’s tweens are more encouraged to voice their opinions, tweens
have more influence than ever regarding how parents spend money.
“Most parents (88 percent) feel their children are at the very least ‘quite fit’” (Disney
Consumer Products). The majority of parents think that schools are providing healthy
meals and are teaching children about healthy lifestyle choices. Almost all parents (94
percent) of the Disney Consumer Product surveyed said that they make a concise effort to
include healthy foods in their children’s meals even
though their children crave sweets and/or are picky
eaters as shown in figure 6 (Disney Consumer Products).
This poses the question: why are children becoming
obese?  Children are eating a greater proportion of their
meals away from home, and meals that are served at
home increasingly originate at “take away” vendors.
These sources are more likely to provide meals and snacks that are high in fat, sugar, and
sodium (Life’s first Great Crossroad).

Many Parents report that their children
crave sweets and are picky eaters
Figure 6


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Secondary Audience:
After school Programs
Although after school programs were originally created in the early nineties to keep
children safe, we have chose to target them because they are designed to help develop and
enrich children’s lives.  Schools are the largest providers of these programs, followed by
YMCA’s, Boys and Girls Clubs, religious organizations, and private schools (Neuman).
Children also spend a large portion of their time at these organizations.
Grocery Stores
Parents buy the majority of home‐cooked meals and ingredients at grocery stores;
therefore grocery stores serve as an important secondary audience.  They are capable of
marketing to people based on product placement, pricing, and promotion.  In Douglas
County, there are 22 grocery stores and 6 specialty food stores (Douglas County Kansas
Business Data). This information may not be useful for the implementation of KDHE’s
portion control campaign but it will serve as an important factor in surveying parents and
tweens to track the success of the campaign.
Environment
The abundance of influences that affect the health of our nation range from the
choices american’s make as individuals to the direct results of the economy and national
policy.


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Marketing
Estimates by the FDC breach the $10 billion mark for money spent on advertising to
children and youth. The Kaiser Family Foundation reported that of the food ads targeted at
adolescents and children, “[a]pproximately a third of the ads are for candy and snacks, a
fourth are for cereal, and a tenth are for fast food. Only five percent are for healthy
foods/beverages such as dairy products and fruit juice. Non are for fruits and vegetables”
(FTC Report 2008). In the tween age group, “25 percent of ads seen by 8‐12‐year‐olds were
for food.” Additionally in the category of children’s shows, targeted at youth under 12,
advertising for food composes 50 percent of all ad time
(highest proportion of all genres) (Food For Thought).
While some blame tween obesity rates on a lapse in
parental judgement, billions of dollars of marketing directed
at children pose a strong opposing factor in the equation.
Companies have adopted playful, child like
characters such as the hamburgler from
McDonalds, [ figure 7, previous page], in
attempts to catch children’s attention. Parents
have to enter head‐to‐head combat against numerous advertising messages in their
childrens’ lives just to ensure the consumption of nutritious food each day. “Parental
authority is undermined by wide discrepancies between what parents tell their child is
healthy to eat and what marketing promotes as desirable to eat” (Guidelines for Responsible
Food Marketing). Additionally, commercials often depict kids engaging in an active lifestyle,
Figure 7
Many companies advertising unhealthy food have
created playful characters to catch children’s eye,
like these created by McDonalds.


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further misleading children and parents to believe that these foods will not have harmful
consequences (Graham).
Guidelines indicate that the following be a nutrition requirement for foods marketed
to children: the product should contain less that 35 percent of total calories of fat and less
than 35 percent of total calories (by weight) of sugar. The guidelines also indicate that
individual serving size should not exceed the standard serving size recommended on
Nutrition Facts Labels and advertised meals should not exceed 1/3 of the calories
recommended for children daily (1800‐2600 for boys ages 9‐13; 1600‐2200 for girls ages
9‐13) (Guidelines for Responsible Food Marketing). In an issue of the Journal of the American
Dietetic Association, it was discovered that if a person were to consume a (daily
recommended) 2000 calories of advertised foods, their diet would provide 25 times the
recommended servings of sugars and 20 times the recommended servings of fat, but less
than half of the recommended servings of vegetables, dairy, and fruits (Mink). “The same
diet would substantially oversupply protein, total fat, saturated fat, cholesterol, and
sodium, while substantially undersupplying carbohydrates, fiber, vitamins A, E, and D,
[etc.]” (Mink).
In conclusion, it is seen that the advertisements and commercials targeting tween
children encourage them to engage in unhealthy eating habits while simultaneously
neglecting such important aspects as fruit and vegetable consumption.


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Packaging
The increased size of single‐serving packages is a 40‐year trend that impacts obesity
rates. Increases in portion size are not only getting bigger calorie‐wise, but are occurring at
a faster rate. The relative price of unhealthy food has also seen a decline in recent decades.
The idea of “more for your dollar”
coupled with the “supersize me” craze
has affected the overall American
outlook on consumption (Ello‐ Martin).
The cost of healthy foods such as
fruits and vegetables has been on the
rise, where as its processed, unhealthy
counterparts continue to see declines in
prices as its popularity rises. The cost of
healthy foods such as fruits and vegetables is
increasingly more expensive than their less
healthy counterparts, (see figure 8).
The importance of economic value has overtaken the importance of healthy
portions. “Children with a higher BMI consumed portions of foods that were as much as
100 percent larger than those consumed by children with a lower BMI” (Ello‐Martin). The
standard size of plates, bowls and even silverware is growing, deceiving the traditional
perception of a portion. Studies show that when presented with a larger portion size,
The price of healthy foods has been on
the rise, while unhealthy foods such
as chips and packaged goods are
experiencing a decline in price.
Figure 8


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tweens will eat more without regard to their actual hunger level. The data showing
increases in portion size directly correlates with the rise in childhood obesity rates, which
indicates an obvious relationship (Anderson).
Caloric Intake
Average daily calorie intake increased by 25 percent, (nearly 530 calories) between
1970 and 2000. Of that 25‐percent increase, grains (mainly refined grain products)
contributed 10 percentage points; added fats and oils were nine percentage points; added
sugars, five percentage points; fruits and vegetables together, two percentage points; meats
and nuts together, one percentage point; and dairy products and eggs together,‐1.5
percentage point (ERS Research Brief).
In 2000, total meat consumption (red meat, poultry, and fish) reached 195 pounds
(boneless, trimmed weight equivalent) per person, 57 pounds above average annual
consumption in the 1950s. Each American consumed an average of seven pounds more red
meat than in the 1950s, 46 pounds more poultry, and four pounds more fish and shellfish.
Consumption of beverage milk declined from an annual average of 36 gallons per person in
the 1950s to less than 23 gallons in 2000. Average annual consumption of cheese increased
287 percent between the 1950s and 2000, from about eight pounds per person to thirty.
Between 1997 and 2000, per capita consumption of added fats jumped 17 percent, from 64
pounds per person to 75 pounds. The annual average use of added fats and oils in the
1950s rose 67 percent by 2002 (ERS Research Brief).


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Family Structure
National
According to the U.S. Census Bureau, the most noticeable change in family dynamics
between 1970 and 2007 has been the decline in married couples who have children, from
40 to 23 percent. During the 40‐year period, 10 percent more people chose to live on their
own, and married couples declined from 87 percent of all households to 75.  The census
also included information regarding differences in households with children between 1950
and 2007. In the 60‐year period, the proportion of family households with children that
were managed by a married couple declined 22 percent, single mother households
increased 17 percent and single father households increased four percent.  The census
concluded that in general, families have been getting smaller with time (Kreider, Eliott).
The role of parents have also changed with time as more parents are joining the
work force and spending more time away from the home. According to the U.S. Census
Bureau, 200 thousand single mothers were in the labor force in 1980 compared to two
million in 2009. In regards to married mothers, six million were in the labor force in 1970
compared with 11 million in 2009 (U.S Census Burea Table 598).  The aforementioned
changes in the home environment likely influence such factors are pre‐prepared meals, and
after school activities geared more toward convenience then health, (Anderson).
Douglas County Households
According to the U.S. census of 2000, Douglas County had 38,500 households, of
which 27 percent had children under 18, and 43 percent included a married couple. Eight


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percent of family householders in Douglas County are single women with no husband
present. The average household size is 2.37 and the average family size is 2.97 (U.S. Census
Bureau).
Breakfast Patterns
A common trend among tweens is to not eat breakfast. This may be because they are
imitating their parents’ eating habits. According to the Breakfast consumer report, The top
two reasons for both parents and children for not eating breakfast were that they do not
have the time and that they weren’t hungry (The Breakfast Consumer Report). Studies have
shown that skipping breakfast can lead to consuming more calories later in a day,
consuming higher amounts of bad cholesterol, and having higher insulin levels, which can
lead to diabetes (Warner).
Transportation to and from school
In 2002, 53 percent of kids got rides to
school from parents and 38 percent walked;
compared to their parents’ transportation habits of
which 70 percent reported walking or riding a bike
to school when they were young. Figure 9 shows a
bus full of kids who won’t be walking to school.
Reasons for increased rates in driving their kids to
school provided by parents include: “too much traffic and no safe walking route,” “fear of
child being abducted,” “not convenient for child to walk,” “crime in the neighborhood” and
Taking the bus to school is becoming more
popular than walking for modern children.
Figure 9


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“your children do not want to walk” as well as the occasional, “school policy against
children walking to school” (Anderson).  The decrease of children walking and biking to
school is one of many contributing factors to a decreasing in childhood physical activity.
Policy
While the FDC takes action against marketing schemes in which children should not
be targeted, their interference has proven minimal and has little effect on the problem.
Other political movements and legislations work to employ major changes in schools,
regulations and corporate responsibility with hopes of seeing a decrease in childhood
obesity.  Most recently on the national level, President Obama signed the Healthy, Hunger‐
Free Kids Act, to reauthorize the Child Nutrition Act. The act includes modifications such as
increased standards and lower costs in school cafeterias, implementing farm‐to‐school
programs, increasing health education and restocking vending machines with healthier
options (Black).
Changes within schools
The meals provided by the School Breakfast Program provide about 25 percent of a
child’s recommended daily calories.

Students often make meals out of à la carte foods and
drinks rather than purchasing school meals. The à la carte foods from manufacturers are
items that are often excessive in size and tend to be lower in nutritional quality.
Community members sometimes question why schools offer à la carte items in addition to
school meals, since the à la carte items are not the healthiest options. (Right‐Size Your
Portions).Foods such as those provided in the à la carte line that compete with the National


Page 31
School Lunch Program meals are often an important part of the school budget which leads
to schools using money raised through competitive food sales to supplement general
budgets. Increased focus on academic accountability, as well as budget cuts occurring
around the nation has made reliance on competitive food income more prevalent. It is also
important to note that both factors contribute to the phasing out of other areas of study,
such as nutrition and physical education, replacing the subjects with the standardized
testing subjects and even reducing the time available for lunch (Anderson).
Former Kansas Governor, Mark Parkinson, has issued budget cuts for both highway
maintenance and education in response to two consecutive years of revenue decline in the
state. He admitted that negative effects will occur across the state, $36 million for K‐12
schools was cut in the 2010 budget (Kansas Governor Cuts Education Budget, 2009). In
continuation to Parkinson’s cuts, Governor Sam Brownback, elected in 2010, proposed
further cuts to the 2011 education spending. These deductions equal a cut in total state
spending on schools of $132 million in the current school year and could result in a loss of
$70 million in federal funds (Kansas governor’s proposed budget cuts, 2011).
AfterSchool Programs
According to the 2009 study, America After 3PM, public schools are the largest
provider of after‐school programs. About 15 million (more than 50 percent) children are
unsupervised at home after school. (America After 3PM). In Kansas specifically, 35 percent
(168,614) of K‐12 youth are responsible for taking care of themselves after school
(Afterschool Alliance in Kansas). Of all Kansas children not currently enrolled in after


Page 32
school programs, 31 percent (132,036) would be likely to participate if an after school
program were available in their community.  Ninety‐five percent of parents in Kansas are
satisfied with the after school program their child attends. Seventy percent of children who
participate in after school programs are in elementary school (America After 3PM).
Physical Education in Schools
Tween obesity rates in Kansas aren’t the only trend that’s changing; physical
education has changed over the years as well. The below information shows how these
changes in school policy effect the education that youth are receiving about healthy eating
practices. Portion control is a big part of learning about the effects food has on the body,
and during physical education is when many kids learn this useful information.
According to the American Heart Association (AHA), nearly
10 million children and adolescents in America are considered
overweight. Physical education is a critical part of the school
curriculum where children receive exercise and learn how to live
healthier lifestyles. There are very few states in America that
require physical education in grades K‐12. School policies and
programs are generally funded and decided at the state and local
levels. The AHA believes that physical education in schools should
be a federal law.
Physical Education is an ideal time to
teach children about healthy lifestyle
choices and eating habits.
Figure 10


Page 33
Research shows that healthy children learn and achieve more academically. Many
schools are cutting back on physical education programs because of financial concerns.
Between ages 9 through 15, physical activity in children drops significantly.  Seventy
percent of states require physical education in elementary schools. Twenty‐two percent of
schools in grades K‐12 do not require students to take any physical education. Physical
education classes popularly consist of physical activities such as basketball, [figure 10],
kickball, and nutritional education.
It is recommended that children get at least 60 minutes of physical activity a day
(Physical Education in Public Schools).  In 2010, the National Association of Sport and
Physical Education (NASPE) and the American Heart Association (AHA) conducted a
research study on the status of physical education in America called Shape of the Nation.
Only six states require physical education in schools K‐12: Illinois, Iowa, Massachusetts,
New Mexico, New York and Vermont.
The Robert Wood Johnson Foundation ranked all 50 states in December of 2009
based on the total number of healthy eating and physical activity regulations for child care
centers and family child care homes. What it found was that the child care centers in
Kansas ranked higher in healthy eating and physical activity than family child care homes.
Economy
Economic hardships create limited affordable resources and a need for alternative
products. The correlation between poverty and obesity rates is a new field of research. The
price disparity between healthy (energy‐dense) and unhealthy foods largely contributes to


Page 34
the obesity rate. According to American Journal of Clinical Nutrition, “refined grains, added
sugars, and added fats are among the lowest‐cost sources of dietary energy” (Drewnowski).
Simply put, the cheaper the food, the less nutritional value it holds.
Restaurants
Researchers predict that between 2000 and 2020, per capita spending could rise by
about 18 percent at full‐service restaurants, and about six percent for fast food.
Changes between the 1990s and the 2000s in restaurant service:
 Full‐service restaurants have increased their menus by adding approximately 32
percent more items (ERS Research Brief: the demand for food).
 Total away‐from home expenditures, including all food dispensed for immediate
consumption outside of the consumer's home, amounted to $263 billion in 1992
versus $415 billion in 2002, (ERS Research Brief: the demand for food).
 Americans are 40 percent more likely to consume meals from restaurants three or
more times a week than they were 20 years ago (Ello‐Martin).
 Portion size increase at fast food restaurants has been estimated to be two to five
times larger than the early 1990s (Ello‐Martin).
Cultural norms and economic value play principle roles in chef portion decisions at
their restaurants. More than 75 percent of executive chefs are serving two to four times the
serving size recommended by the US government (Condrasky). In addition to larger


Page 35
Figure 11
McDonald’s is the world’s
leading fast food restaurant.
portions, a conclusion drawn from Economic Research Service found that food consumed
out of the home has a higher ratio of fat to calories, and lower fiber and calcium densities
than foods prepared at home (Lin).
*Note: There are 260 restaurants listed within a 20‐mile radius of Lawrence, KS (Kansas
Yellow Pages).
Competition
Direct Competitors:
In our quest to provide social awareness for the prevention of tween obesity in
Douglas County, our client’s direct competitors are anyone who tries to enforce the
opposite attitudes and beliefs of the healthy habits KDHE is trying to instill. The most
influential of these are fast food and family restaurants that encourage large portions and
intentionally advertise “economic value”.  Fast food is the strongest direct competitor for
these reasons, as well as the fact that they spend a large sum of their advertising dollars on
advertising specifically to tweens.
According to a study conducted in February 2011, the top three fast food
restaurants in the nation, in order, are McDonald’s, Burger King and Wendy’s
(NYJobSource.com).
Fast Food Restaurants
McDonald’s
McDonald’s® is the world’s leading fast food


Page 36
restaurant. It has more than 32,000 restaurants in 117 countries. There are currently ten
McDonald’s® locations near Douglas County, Kansas (mcdonalds.com). It serves as a
competitor to our client’s goal in that it encourages larger portion sizes recommended for
children ages 9‐13. Boys 9‐13 are supposed to consume 1800‐2600 calories per day and
girls ages 9‐13 are supposed to consume 1600‐2200 calories per day (livestrong.com).
Additionally, the recommended sodium intake for children ages 9‐13 is 1500‐2000
milligrams per day (bcm.edu). Both the McDonald’s® “Happy Meal” as well as its “Mighty
Kids Meal” does not encourage such healthy portions. In a McDonald’s® healthy “Happy
Meal” with chicken nuggets, apple slices and milk there are 450 calories, 15 grams of fat
and 590 grams of sodium. However, among tweens, choosing the healthy option as listed
above is not always the most popular option. The calorie count in a McDonald’s® “Happy
Meal” including a cheeseburger, fries and a 12 oz. sprite is 640. In a “Mighty Kids Meal” of
chicken nuggets, apples and milk there is 540 calories, 51 grams of fat and 790 mg of
sodium. As can be expected, the “Mighty Kids Meal” jumps in calories when they bypass the
healthy option. A meal with a double cheeseburger, fries and a 16 oz. sprite is 820 calories.
The portion sizes at McDonald’s® have increased significantly overtime. In the
1950s McDonald’s® only offered a small 2.4 ounce fry and today they offer servings up to
seven ounces (ces.ncsu.edu). Additionally, McDonald’s® employees automatically give
young customers fries 84 percent of the time and soda 55 percent of the time without even
offering the healthier options (Brownell, 2010). These numbers account for almost half of
the daily‐recommended intake for tweens and if they are getting the recommended three
meals a day they are well over their limit (nutrition_lists, 2011).


Page 37
Figure 12
Part of the reason for concern is that McDonald’s® is increasingly attracting
consumers by marketing to a younger audience. McDonald’s® recently agreed to decrease
marketing to young audiences, however, in 2009 children ages 6 to 11 saw 26 percent
more advertisements from McDonald’s® than they did in 2007 (Brownell, 2010).
Increasing attention is focused on its methods of advertising. In December 2010, a mother
in California filed a lawsuit against the company for using ads targeted at children as well
as offering toys in their “Happy Meals” to attract young consumers. She claimed, “Because
these children do not understand marketing, they are inherently deceived by the
marketing, just as adults are deceived by deliberately misleading advertising.” As a result, a
new law has been passed in California that only allows toys to be given out in healthy
“Happy Meals” and not those that come with fries and soft drinks (Cragg, 2010).
Considering that this decision was just put into action, little research has been conducted to
measure the results of this change.
The McDonald’s® Web site is dipping into the world of social media with links to
Twitter, Flickr, Youtube and Facebook.
Burger King
Burger King® is the second most popular fast food restaurant in the nation with
three locations near the Douglas County area. The lowest calorie meal on the Burger King
Kid’s menu totals 510 calories.  The company is also guilty of increased portions over time.
Burger King’s® hamburger was 2.8 ounces in 1950 with 210 calories whereas today it is a
4.3 ounce patty with 310 calories (ces.ncsu.edu). Burger King® has a particularly close
Burger King is the
second most popular
fast food restaurant.


Page 38
interest in the tween age group in that it is partnered with Nickelodeon® and
DreamWorks®. The three companies originally partnered in 2001 in an effort to build a
mutually beneficial relationship where Burger King® gained access to innovative media
and DreamWorks® and Nickelodeon® gained access to Burger King’s® extensive clientele
(qsrmagazine.com). Burger King® has an edge over McDonald’s® in that some of its kid’s
meals are actually considered healthy, whereas none of the meals offered by McDonald’s®
are. In July 2010 Burger King® set a new standard for their kid’s meals. In an effort to
prove that the company is becoming more health conscious, they set the following
standards for four of the kid’s menu items:
 No more than 560 calories per meal
 No more than 600 milligrams of sodium
Even though Burger King is promoting new standards for Kid’s Meals, it is clear that
they are far from a healthy option. Looking at the caloric recommendation for children ages
9‐13 (boys: 1800‐2600 calories per day; girls: 1600‐2200 calories per day. Sodium intake:
1500‐2000 milligrams per day), consuming the “standard” meal at Burger King for
breakfast, lunch, and dinner, children would stay within the recommended calories, but
would be consuming mostly empty ones and high levels of sodium.
In addition, Burger King pledged to decrease advertising for all kids’ meals that do
not meet the above restrictions (nacsonline.com). Burger King® has, however, received a
lot of criticism for campaigns targeting tweens in the recent past. In 2009, the company
faced negative feedback for a commercial featuring SpongeBob Squarepant’s Kids Meals.


Page 39
Wendy’s was
ranked the third
most profitable
fast food
restaurant in the
U.S.

The ad used the song “Baby Got Back” and showed women shaking their behinds. Another
d featured SpongeBob Squarepants sitting on the couch with two women and proclaiming,
“booty is booty.” Critics argued that the ads should be pulled based off of the fact that they
use cartoon characters to promote unhealthy eating as well as their use of “sexualization”
in advertising to minors (Golin, 2009). As a result they lost 18 percent of their market share
in 2009, all of which seemed to go to giving McDonald’s® a rise in profits (Monica, 2009).
Wendy’s
Wendy’s® is the third‐most profitable fast food restaurant
in the United States and made $3,580.3 million. There are
currently two Wendy’s® in the Douglas County area. At
Wendy’s® the lowest caloric Kid’s Meal contains 460 calories and 14.5 grams of fat, which
is an improvement from both Burger King and McDonald’s®, but not significantly
(wendys.com). The company was bought out in 2011 by Triarc (the group that owns
Arby’s®), which renamed itself Wendy’s Arby’s Group®. The group then put Arby’s® up
for sale to focus on Wendy’s® seeing as it is the more profitable of the two restaurants
(adbrands.net).
Wendy’s® is currently expanding their marketing strategies by targeting a younger
audience through the use of social media. Their website features links to Facebook, Twitter,
Myspace and Youtube. Also, during the summer of 2010 they launched a Frosty Summer
Vacation campaign where Facebook users could track “Frosty’s” whereabouts and receive
digital postcards from the fictional character. They were then able to find clues in the
Figure 13


Page 40
postcards that navigated them through a Wendy’s® fan page where they could collect more
clues and get themselves entered into contests to win a minimum prize of $25.00 and a
grand prize of a trip to Hawaii or Alaska. The company also used a “Treat it Forward”
campaign on Twitter, Facebook and Foursquare to help raise funds for the Dave Thomas
Foundation for Adoption (Van Grove, 2010). Additionally, the company has received
criticism for its most recent advertisement of its new sea salt fries. Critics claim the
advertisements suggest that the fries are healthier and the ingredients are more real. In
reality the fries contain the same amount of fat and calories as the old fries and also have
140 more mg of sodium (yaleruddcenter.org).
Each of the above fast food restaurants has agreed to get rid of its “biggie,”
“supersize,” and “king size” options on its menu; however, rather than actually taking these
items off of the menu, they have simply been renamed “large” (Young and Nestle, 2007).
Family Restaurants That Offer Kids Eat Free
Since the nation has faced economic turmoil, more and more restaurants are
offering free meals for kids in order to encourage more families to eat out (msnbc.com).
Many of these offers include unhealthy options for kids, but are more appealing to parents
because they don’t have to pay. Some of the most popular of these restaurants in Douglas
County and what they offer are listed below:
 Buffalo Wild Wings, $.99 Kids Meals on Sunday.
 Local Burger, Kiddie Burger Combo Meal 1/2 Price on Sundays


Page 41
 Yellow Sub, Free kids meal with an adult meal
 Set ‘em Up Jacks‐kids eat free
 Cici’s Pizza, 3 p.m.‐close (Kids 12 and under eat free Tuesdays, kids 3 and
under are always free)
 Godfather’s Pizza, (Kids Buffet Free, 10 and under, with each adult)
 Perkins Family Restaurant‐kids eat free from 4 p.m.‐10 p.m.
 Salty Iguana Children 12 and under eat free off kids menu with paying adult.
 Stone Creek (Limit 2 children with each adult entree purchase.)
 Jason’s Deli – kids eat free with adult entrée, 4 p.m.‐close (Through
August)
 Steak ‘n Shake – 1 kid’s plate free with each $8 purchase
Nutritional Information of Local Restaurants where Kids can Eat Free
Calories Total Grams of
Fat
Buffalo Wild Wings
Kid's Menu w/ 4 Boneless Wings & Fries 568 30g
Cici's Pizza
Slice of Pepperoni 160 4.5g
Slice of Cheese 150 4g
Jason's Deli
Baked Potato 799 49g


Page 42

The restaurants listed in the table above were the only ones from the list on pages
40 and 41 that agreed to disclose the kids’ menu nutritional facts. Even with only four
Douglas County restaurants, the majority of these meals don’t meet recommended serving
Pasta & Meatballs 500 21g
Kid's Pepperoni Pizza 484 21g
Cheese Pizza 470 20g
Grilled Cheese 433 26g
Macaroni & Cheese 420 23g
Chili Dog 413 21g
Ham & Cheese Sandwich 371 12g
Peanut Butter & Jelly Sandwich 359 11g
Turkey & Cheese Sandwich 331 9g
Hot Dog 283 14g
Ham & Cheese Wrap 241 10g
Turkey & Cheese Wrap 241 9g
Perkin's
Classic Kid's Cheeseburger 1060 64g
The Kid's City Slicker 970 31g
Kid's Dollar Pancakes 830 26g
Chicken Tenders 720 50g
Quesadilla 660 35g
Kid's French Toast Tower 530 21g
Kid's Cheese Pizza 390 16g
Steak 'n Shake
Grilled Cheese & Fries 610 36g
Steak Frank & Fries 540 34g
Peanut Butter & Jelly Sandwich w/
Applesauce
530 23g
Steakburger w/ Cheese & Fries 480 23g
Steakburger Minis(2) w/ Cheese & Fries 460 24g
Peanut Butter & Jelly Sandwich 450 23g
Steakburger & Fries 430 19g
Steakburger Minis(2) & Fries 400 19g
Chicken Fingers(2) & Fries 390 19g
Macaroni & Cheese w/ Applesauce 260 5g
Macaroni & Cheese 170 5g
Table 1


Page 43
sizes for tweens. While these establishments don’t necessarily advertise to tweens, they
advertise heavily to KDHE’s other target audience and primary money spenders, parents.
Brands That Market to Tweens
Tweens are exposed to an enormous amount of advertisements for unhealthy food.
On the popular television station Nickelodeon, 80 percent of the advertisements are for
non‐nutritional foods. A study by CSPI in 2009 found that “of the 452 foods and beverages
that companies say are acceptable to market to children, 267, (or nearly 60 percent), do not
meet CSPI’s recommended nutrition standards for food marketing to
children”(cbsnews.com). This includes such items as kid’s cereals, Goldfish®, and Kraft®
Macaroni and Cheese. Each of these companies uses bright colors, famous cartoons,
personification and other things to entice kids into buying its product.
Cereals
Some of the cereal companies that spend the most
on marketing to children and teens are General Mills at
$107 million in 2009, Kellogg with $39 million in 2009
and Post with $10 million in 2009 (Rudd Center, 2009).
General Mills advertises the following cereals directly to
kids and teens: Cinnamon Toast Crunch, Cocoa Puffs,
Cookie Crisp, Honey Nut Cheerios, Lucky Charms, Reese’s
Puffs and Trix [figure 14]. They also market
Figure 14
Cereals that market to tweens contain bright
colors, funny characters, and are placed lower to the
ground within a child’s line of sight.


Page 44
other sugary cereals such as Cinnamon Toast Crunch, Lucky Charms and Count Chocula.
Kellogg markets the following to kids and teens: Apple Jacks, Corn Pops, Froot Loops,
Frosted Flakes. Post markets the following to kids and teens: Honeycomb and Fruity or
Cocoa Pebbles (Rudd Center Report, 2009).
Goldfish
Goldfish saw great success in marketing to tweens in 2004 when
they reintroduced “flavor‐blasted Goldfish” with brand new flavors. The
company had a 43.4 percent increase in dollar sales within the first two
months (Elliot, 2004). The company also has an interactive website for
kids and teens to play games and win prizes as well as colorful packaging
and cartoon fish [figure 15]. Kids can become members of the
site and play with Finn the friendly mascot (goldfishfun.com).
Kraft Macaroni and Cheese
Kraft has an interactive website directly linked to nick.com
(Nickelodeon). On the website you can play games and learn interact
with characters from the Nickelodeon network. The product itself comes
in versions shaped like SpongeBob Squarepants, Scooby Doo and Toy
Story, each one is playfully presented on the package, [figure 16].
Additionally, the mascot for the brand is a friendly looking orange dinosaur named
CRex (kraftfoods.com).

Pepperidge Farm goldfish use
playful games and colors to
appeal to children"
Kraft targets children
with creative and fun
noodle shapes

Figure 15
Figure 16


Page 45
Figure 17

Antitobacco
campaigns are a
good example of
successful social
awareness
campaigns.
Indirect Competitors
Anti‐smoking, drug, violence and sex campaigns directed at tweens are considered
indirect competitors because they compete for airtime and attention from the tweens in
our target audience. When the tweens are consuming information regarding these other
messages, as beneficial as the messages may be, they are not focusing on our client’s chosen
goal; the fight against obesity. Examples of currently airing campaigns and organizations
directed towards tweens are as follows.
Youth AntiSmoking Campaigns
“Campaign for Tobacco Free Kids” According to its 2009 annual
report, the organization spent $17,497,910 promoting
communications, outreach and research towards anti‐smoking campaigns in 2009 alone. In
addition to publishing multiple anti‐smoking reports including “Deadly in Pink,” an article
speaking out against tobacco marketing to girls, the organization hosts a nationwide,
annual “Kick Butt Day.” Launched in 1996, this day of activism takes place in schools and
community centers and encourages children to create “for kids‐ by kids” anti‐smoking
messages in the forms of videos, pictures, and signs for lobbyists. Each year the
organization also awards seven “Youth Advocates” of the year.  The organization has also
partnered with “Faith United against Tobacco,” a church based program in which priests
and ministers are trained to encourage the youth of their ministries to avoid smoking. The
religious groups participating in the campaign include United Methodists, Presbyterian,


Page 46
Seventh Day Adventists, American Methodist Foundation, Southern Baptist Convention and
many more (Myers).
“The Foundation for a Smoke Free America” is an organization
motivated by R.J. Reynold’s (founder of Camel and Winston cigarette
brands) grandson, Patrick Reynolds. The organization’s goal is to
prevent youth smoking via its website and school based educational programs. Patrick
Reynolds travels to middle and high schools nationwide leading assemblies regarding the
negative effects of tobacco on his family’s health and encouraging children to stay tobacco
free. The content of his speeches include showing ads targeted towards children to build
awareness of the industries goals, these ads include pictures of young girls in swim suits,
tobacco “fun” flavors including mocha mint and berry blast as well as KOOL brand
packaging complete with a hip hop DJ party. According to the organizations 2006 annual
report, Patrick Reynolds personally spoke to 17,375 school aged children during one year.
The Foundation’s primary website www.Anti‐smoking.org was ranked number one in
Google results under the term “quit smoking.” The foundation created two video’s “The
Truth about Tobacco” and “Talk with your Kids about Smoking,” they estimate that
approximately one million two hundred thousand children will see the videos annually.
The Foundations yearly budget totaled at $195,846 which left them in a deficit. Seventy‐
five percent of the children who viewed the assemblies reported they would recommend
the presentation to a friend, 90 percent agreed they were more optimist of their future
health as a result of the presentation, and 78 percent of the children agreed the
Figure 18
“The
Foundatio
n for a
Smoke
Free
America.”


Page 47
presentation changed their way of thinking about tobacco (Foundation for a Smoke‐Free
America).
Youth AntiDrug/Violence Campaigns
D.A.R.E. (Drug Abuse Resistance Education) was
founded in Los Angeles in 1983 and has since been implemented in 75 percent of American
schools and 45 foreign countries. President Obama declared April 8, 2010 “National
D.A.R.E. Day.” The program focuses on anti drug, violence and gang activities. D.A.R.E. is a
police officer led series of classroom lectures that targets school aged children from
Kindergarten through 12th grade. (D.A.R.E. home‐page). The program uses a cartoon lion
mascot named Daren to promote interest in younger children as well as a youth targeted
website that includes signs of “ Kids Only!” safety tips, games, and a forum to include
personal essays, songs, puzzles and shout outs.  The D.A.R.E organization has three
different curricula for elementary, middle, and high school; the middle school curriculum is
entitled “Keepin’ it Real” with an emphasis on peer pressure and acceptance.
Implementation of the D.A.R.E. program is a community decision and has been
implemented by more than 10,000 communities in the U.S. Its 2009 annual report shows
that funding is in decline, falling from $6,596,928 in 2008 to $4,485,892 in 2009; the money
comes in the form of grants, contributions, fundraising events and license royalties. The
organization’s 2009 expenses of $5,560,901 were not fully covered by the funding (D.A.R.E
Annual Report).

Figure 19
D.A.R.E
was
founded in
1983.


Page 48
“SAVE” was founded in
1989.
“SAVE” Students Against Violence Everywhere” was founded in
1989 in North Carolina and has since grown by approximately 2,000
new members a month with over 1,800 SAVE chapters in the U.S.
The program is run for students, by students with a focus on
providing education about the consequences of violence and helps
provide safe activities for students, parents, and communities. The material is implemented
as either curriculum in elementary schools or as clubs in middle schools. The non‐for profit
received the President’s service award in 1995.  Every year the organization declares a
“SAVE Day” during national safe schools week; during the day schools and communities
involved participate in rallies, assemblies, and member drives. This organization focuses on
children’s time in school with assemblies and curriculum as well as out of school via clubs.
Their target age group ranges greatly from elementary through college‐aged children
(SAVE).
Youth Targeted Public Service Announcements
The Kansas Immunization program posted a 30 second long video on Facebook
regarding youth flu vaccinations. The Public Service announcement was posted in
November of 2010 with the intention of convincing elementary/middle school aged
children to get the flu vaccine. Because the video was incorporated onto a social
networking site it had the ability to go viral (Facebook).
The World Health Organization aired a video for “World No Tobacco Day” on May
31st.  The message of the video is that the Tobacco industry uses movies to convince youth
that smoking is cool while they are still young. The motive of the public service
Figure 20


Page 49
announcement is to ban all tobacco advertising, promotion, and sponsorship. The video
was posted on YouTube and currently has 1,804 views; it is also a part of The World Health
Organizations Tobacco Free initiative web page. The internet site an interactive page that
provides visually appealing information regarding the tobacco industry and its negative
goals. Other videos produced by the World Health Organization include the animated
“Tobacco Free Youth and Fashion” and the music video, “Tobacco Free Youth.” (World No
Tobacco Day).
The Possibility Project is an organization based out of New York City that targets
youth and teenagers with a goal of bettering the world through safe sex and youth
empowerment. The team members meet after school or on the weekends multiple times a
week to creatively express their social and economic situations via plays, musicals, poetry
slams, flash mobs, etc. The non‐for profit’s flash mob video on YouTube entitled “Safe Sex
Flash mob” had 4, 848 views in May, 2011 and pushes the message “wrap it up,” which
promotes condom use in youth. The organization is very active on such social media sites
as face book, twitter, and Flickr, using them as portals to easily and quickly spread its
message to youth (The Possibility Project).


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Research Analysis
PARENTS
Demographics for Parents
In targeting parents of tweens in Douglas County we felt it was best to use surveys
and interviews considering the busy schedule of parents. We set out to collect these by
visiting grocery stores. We visited Wal‐Mart, Hy‐Vee, Aldi, Checkers and The Merc.
Additionally, we visited popular outdoor locations such as public baseball and soccer fields,
and Massachusetts Street where we used a mall intercept strategy to accumulate surveys.
Initially, we found that it was hard to get people to participate in surveys on the spot so we
modified our approach by creating flyers with a URL to an online version of our surveys.
This proved successful as our numbers began to increase significantly. We then handed out
the URL slips to parents picking up their children from Girl Scout and Boy Scout meetings
in Lawrence as well as the afterschool program “Boys and Girls Club.”  In total we surveyed
88 parents: 90.7 percent of these were mothers, 72 percent were married and 17.3 percent
were divorced. The majority of the respondents (57.3 percent) were between the ages of
35‐44. 38.7 percent of the parents had a Bachelor’s degree. The parents reported the
following incomes [Figure 21].

Parent Income
1.3% 5.3%
4.0%
4.0%
2.7%
8.0%
14.7%
5.3%
8.0%
8.0%
20.0%
8.0%
10.7% Less than $10,000
$10,000 to $19,999
$20,000 to $29,999
$30,000 to $39,999
$40,000 to $49,999
$50,000 to $59,999
$60,000 to $69,999
$70,000 to $79,999
$80,000 to $89,999
$90,000 to $99,999
$100,000 to $149,999
$150,000 or more
Pref er not to answer
Figure 21  Parent Income


Page 51

Significant response analysis
The following sections address specific questions from our parent survey.
 61.5 percent of 78 participants say that they cook at home 4‐6 times a week [figure
23]. This is important because we figure the large portions are coming from the
home. This proved different from our secondary research, which suggested portion
control was mostly a problem from eating out. This proves it is actually a
combination of portion choices at home and eating out.

 32.1 percent of 78 participants say that it is extremely important to eat meals as a
family.
 71 percent of parents say they eat fast food 1‐3 times a week.
 Tweens often decide what to order 48.1 percent of the time when eating out, and
32.5 percent always decide.
How Often Parents Cook at Home
37.2%
41.0%
20.5%
1.3%
One a day
Two a day
Three a day
More than three a day
Figure 22 How Often Parents Cook at Home
20.5
percen
t
1.3
perce
nt
37.2
percen
t
41


Page 52
Reading with tweens about
health matters opens room
for educating them in a fun
way.
 44.2 percent of parents: price plays a large part of making someone loyal to a store.
35.1 percent say location. Important to reiterate what we learned in secondary
research that parents in Douglas County follow trend of rest of America.
 Educating the tweens. Parents say they try to educate their tweens. We should
educate them so that they talk often about portion control. 57.4  percent said it 9 or
10 in importance to talk to their tween. 61.3 percent often talk to their tween.
 67.5 percent of parents (50) checked “yes” to their tween being in the healthy BMI
range but only 9 parents knew what that range was when asked “if yes, please
specify what that range is”. 22.5 percent checked “I don’t know” and another 8
responded that they didn’t know in the “if yes, please specify what that range is”.
 53.3 percent of parents say that the pediatrician never influences their decisions
about meals. This is interesting and will help us
understand how much influence to place on
encouraging pediatrician influence because if parents
don’t listen to the doctor, it’s not worth investing.
 61.3 percent of parents say they often talk to
their tweens about health. We should look into
investing in parent education because they can relay
the correct information to their tween.
 57 percent of parents think that advertising
influences tweens behavior.
 40 percent say body image rarely influences
their tweens eating behaviors.  This shows that tweens’ eating habits are not
focused around diets or image.

Crosstabs
 Bottom 13 respondents of income level refer most to price when determining where
to shop. (less than $10,000 – $49,999).
Figure 23


Page 53
 Top 16 respondents of income level refer most to location when determining where
to shop. ($70,000$– $99,999)
 Out of 88 parents surveyed, 26 parents had tweens that fell into either the
overweight or obese category based on their BMI percentile. Only one of these
parents reported knowledge that their tween was obese.
 The majority of parents with obese tweens are in the $60,000‐$69,999 income
range. The second highest number of parents with obese tweens fall in the $50,000‐
$59,999 income range.
 The majority of the surveyed parents who had obese tweens had achieved either a
Bachelor’s or Master’s degree as their highest level of education.
 The same amount of parents with obese tweens reported having a tween who was a
picky eater as those who reported having a tween who was not a picky eater.


Page 54
Snacking and Income

TWEENS
We aimed to survey tweens in places that they would visit with their parents seeing
as we required parental consent. We visited local grocery stores such as Wal‐Mart, Aldi, Hy‐
Vee, Checkers and The Merc. In addition, we surveyed tweens on Massachusetts street and
at local parks in Lawrence. If the tween’s parents asked for a URL sheet to fill out the
survey online we encouraged them to allow their tweens to participate as well with our
online tween survey. We found the most success when we surveyed tweens at after school
programs such as Girl Scouts, Boy Scouts, and Lawrence Boy’s and Girl’s Club. We attribute
our success here to the fact that the tweens were confined to one area for several hours.
Figure24
There is a correlation between
the amount of snacks
consumed and income.


Page 55
We surveyed a total of 91 tweens with 44 percent of these being boys and 56 percent being
girls. The respondents break down into the following age groups:
 (10) 8‐year‐olds
 (14) 11‐ year‐olds
 (25) 12‐ year‐olds

The following sections address specific
questions asked on our tween surveys.

Significant response analysis
 Eating out according to tweens.
 1‐3 times a month: 48.8
percent
percent
percent
 Where do you learn about which kind of foods you should eat? (Respondents could
check more than one.)
 School/Teachers‐ 72.1 percent  (62)
 Parents‐ 61.6 percent (53)
 TV‐ 29.1 percent (25)
 Friends‐ 26.7 percent (23)
 We saw this as significant evidence supporting many of our online
sources that stated tweens are heavily influenced by their parents.
 Tweens see the most ads on TV (60.7 percent)
The majority of families in Douglas
County eat out 13 times a month.
Figure 25


Page 56

Crosstabs Boys & Girls
 What do you like to do in your free time?
o Boys‐ tied with liking to hang with friends and sports.
o Girls‐ like hanging with friends.
Crosstabs Ages (8, 10, 12)
 Where do you learn about what kinds of foods you should eat?
o 8‐ year‐olds: 6/10 think they get their info from teachers.
o 10‐year‐olds:  11/21 get information from teachers, 10/21 from parents.
o 12‐ year‐olds: 19/25 said parents, 17/25 said teachers, 9/25 said friends.
 Can see growth and change in influence or awareness of what influences
them.
 Surfing online is generally the least desired activity out of /sports/hanging out with
friends/watching TV.

Commercials Tweens Say They Like the Most
78.2%
32.2%
17.2%
46.0%
8.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
Funny commercials Sports commercials Commercial with kids
your age in them
Commercials with movie,
TV or music stars
Other (please specify)
Commercials that Tweens like the Most Figure 26
78.2
percent
Funny Commercials Sports Commercials
32.2
percen
t
Commercials with kids
your age in them
17.2
percen
t
Ones with movie,
TV, or music stars
46.0
percent
Other (please specify)
8.0
perce
nt
Tweens in Douglas County report liking
funny commercials the most.


Page 57
COMPARISON
Comparison of Influences
 Tweens say that School/Teachers and Parents influence their choices most
 Only 7.8 percent of parents thought that school influences their children
o Tweens selected school as their primary source of education for healthy
eating (parents second)
 45.3 percent of parents felt their kids just bought whatever they had tried before
(repeat buyers)
Comparison of deciding what to order
 Both tweens and parents said that tweens decide what to order mostly based on
what is on the kid’s menu
o Parents: 64 percent
o Tweens: 36.9 percent
 Parents second highest ranking was that the option was healthy
 Tweens second highest ranking was that it was a repeat order

INTERVIEWS
We interviewed a total of 5 parents about the behaviors of their tweens. Among
these five parents there was a total of 8 tweens discussed. The interviews took place in the
respondent’s homes. The following sections
demonstrate the conclusions.
Media Use Influence
 TV
o Advertising that is remembered most:
cereal and toys [figure 22]
o Watch Disney and Nickelodeon most
often
 Online
o Advertising: no influence
Figure 27 Marketers target tweens by
using friendly cartoon
characters.


Page 58
o Older tweens spend time on social media sites

Health Conscious Tweens and Parents
 Both parents and tweens know eating healthy is important but that doesn’t make
them do it.
 Is eating healthy important to you?
o “Um. I would say it’s very important, although I often don’t eat healthy.”
 Is your tween conscious of the impact of eating healthy versus not eating healthy?
o “He is but, as a general rule, he would pick the unhealthy thing every time.”

Parents remember easy ways to control portion sizes
 Pediatrician influence (though our surveys showed that parents didn’t get much
advice from pediatricians, some of our interviewees recalled tips they had received
from their pediatricians about healthy eating habits.)
 Advice from friends
 General knowledge

CONCLUSIONS FROM PRIMARY RESEARCH
 Data suggests that parents who are from lower household income levels are more
likely to be aware of obesity as a problem. We know from secondary research that
childhood obesity is more prevalent in lower income families. This implicates that
people from higher income families see obesity of less of a major problem because it
is less present in their lives.


Page 59

 67 percent of parents believe that obesity is a problem in Douglas County.
 15‐19 percent of Douglas County parents believe that lack of portion control is the
main contributor to childhood obesity. Too little exercise is ranked number 1 and
fast food intake is ranked number 2.
 Favorite TV stations: Nickelodeon and Disney.
 Tweens are not yet in tune with Facebook and Twitter.
o They enjoy video games and sports. Like spending time with their friends at
and after school. Tweens report that they spend quality time with their
family during dinner or watching TV shows.
Figure 28
Most parents who had
overweight or obese
tweens were
unaware.


Page 60


Page 61
KDHE Promoting Portion Control

Strengths
 Protects the well‐being and health of
Kansans
 Promotes responsible decision‐
making
 Implements programs to help
maintain a healthy and safe
environment for all Kansans
 Partners with other health programs
to ensure a well‐rounded avenue for
their provided services

Weaknesses
 Weak presence in the community
 Analogous audience
 Uncertain goals in the eyes of the
community
 Weak information regarding
childhood obesity statistics in
Douglas County
 Promoted a poor public image by
recently approving Holcomb power
plant

Opportunities
 Tweens that are technologically savvy
 Tween interest and time spent in a
variety of media outlets (i.e., TV,
radio, etc.)
 Personified characters as celebrity
endorsed advertising
 Social Media
 Parent target audience is
impressionable
 Parents want best for their tweens
 Tween obesity is prevalent.
 Consumer confidence is increasing
 Tweens model parent’s behavior
 Tweens are conscious about body
image

Threats
 Budget cuts
 Rapid growth in health‐related fields
that would require changes to the
current programs
 Traditional media has a weak reach
to tweens
 Potential negative response of tweens
to celebrity endorsements, social
media etc.
 Difficult target audience due to
disparity in age range

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