The message changes belief and the rest is theory: the "1% or less" milk campaign and reasoned action.

BACKGROUND: Theory-based approaches to public health interventions are useful for designing, implementing, and evaluating research. This paper describes and presents data to support the theoretical force behind the "1% or less" nutrition intervention studies. METHODS: Using the Theory of Reasoned Action (TRA), high-fat (whole and 2%) milk users were targeted. Supermarket milk sale data were collected, and randomly selected intervention and comparison community residents were surveyed via telephone to assess milk use. TRA constructs were used in the surveys that were conducted immediately before and after a 6-week mass media campaign. Campaign messages were aimed at changing behavioral rather than normative beliefs. RESULTS: We found significant and predicted changes in intervention participants on intention, attitude, and behavioral beliefs, but not subjective norm outcomes. A path model showed support that TRA variables mediated significant changes in self-reported milk use. CONCLUSIONS: The analysis further validates the TRAs and supports a template using both the Principle of Compatibility and TRA to aid development and implementation of messages for effective behavior change field interventions.

Wheeling Walks: a community campaign using paid media to encourage walking among sedentary older adults.

BACKGROUND: Mass media may effect communitywide changes in health awareness, attitude, and behavior, but the approach remains unproven for physical activity. METHODS: Wheeling Walks promoted walking among sedentary 50- to 65-year-old adults in a West Virginia city of 31,420 people. This quasi-experimental communication intervention used theory of planned behavior and transtheoretical model constructs to change behavior by promoting 30 min of daily walking through paid media, public relations, and public health activities. Impact was determined by pre- and postintervention telephone surveys with 719 adults in the intervention community and 753 adults in the comparison community and observations of walkers at 10 community sites. RESULTS: Behavior observation showed a 23% increase in the number of walkers in the intervention community versus no change in the comparison community (OR = 1.31, 95% CI = 1.14-1.50). Thirty-two percent (32.2) of the baseline sedentary population in the intervention community reported meeting the CDC/ACSM/Surgeon General recommendation for moderate-intensity physical activity by walking at least 30 min at least five times per week versus 18.0% in the comparison community (OR = 2.12, 95% CI = 1.41-2.24). The intervention community also realized a pre to post increase in positive stage change (P < 0.001). CONCLUSIONS: This theory-based mass media campaign demonstrated increases in those meeting the recommended standard for moderate-intensity physical activity through walking and significant positive stage change.