The Public Education Committee adopted a philosophy which took into consideration the social context of health related behaviours. It was committed to citizen participation in defining community problems, designing community programs and evaluating their effectiveness. The committee decided to take a two- pronged approach to public education -- community activation and social marketing.
Five demonstration sites were chosen to implement the community activation approach, of which four were rural communities.
The community action process was used to assist the demonstration communities in planning their heart health activities ([Bracht et al, 1990]). This process assists individuals and communities to identify their own health issues and decide what to do about them. The process used by the local communities consisted of assessing community needs and resources; forming partnerships; and planning, implementing and evaluating heart health initiatives.
The outcome of this process was the development and implementation of many creative programs related to a variety of health issues including nutrition, physical activity, smoking, leadership, and community spirit. The communities made some policy and environmental changes to support a heart healthy lifestyle. In addition, beneficial spin-off activities of the community action process included capacity building of community members, leveraging of funds for community activities, and an expansion of traditional community networks. Evaluation information was collected through interviews and questionnaires, and quarterly reports submitted by the community coordinators. In general, the results suggested the community action process was successful in activating community residents to plan and implement heart health programs.
The goals of Heart Health Nova Scotia's social marketing campaign were to motivate young men to lower their fat intake and to motivate young women to quit smoking. The campaign was a collaborative effort of over 20 community organizations. Campaign strategies were based on formative research with the target populations, which included focus groups across Nova Scotia.
Targeted radio and television commercials were developed and aired across the province. Each commercial encouraged the target audience to call a toll-free telephone number for free information. Calls to the 1-800 information line for information on nutrition were answered by trained volunteers at the Heart and Stroke Foundation of Nova Scotia, where a dietitian was on hand to answer any detailed questions about nutrition. Calls to the information line for help to quit smoking were answered by trained volunteers at the Lung Association of Nova Scotia, where a smoking cessation counsellor was available to help callers with special needs. As part of ongoing media relations, seven news features on smoking cessation, physical activity and nutrition were developed and aired on a provincial television station. A Maritime-wide Test your Heart Health Know-How contest was incorporated into these news features to increase viewer participation.
The evaluation estimated the media reach and effect on the target populations and examined the operation of the 1-800 lines, caller satisfaction with the information and service, and 1-800 line volunteer satisfaction. Results of a province wide telephone survey (N = 264) showed that 40% of young men in the target population recalled the nutrition ad. Results of a mall intercept survey (N = 88) showed that 60% of young women smokers recalled the ad. A telephone survey of 1- 800 number callers showed a high level of satisfaction with the information and service for both the nutrition and smoking cessation lines. The volunteers who received the calls at the 1-800 service managed their responsibilities effectively, and were very satisfied with their experience.
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