Evaluation of the population-level impacts of the LiveLighter® obesity prevention campaign from 2012 to 2019 based on serial cross-sectional surveys

BACKGROUND

Halting and reversing the upward trend in obesity requires sustained implementation of comprehensive, evidence-based strategies at the population-level. The LiveLighter® program targets adults using a range of public education strategies, including mass media campaigns, to support healthy lifestyle changes to attain or maintain a healthy weight and reduce the risk of chronic disease. LiveLighter® has been implemented in Western Australia (WA) since 2012 and, to our knowledge, includes the longest running adult-targeted mass media campaign for healthy weight and lifestyle promotion and education globally. This evaluation assessed the impact of LiveLighter® on WA adults' knowledge, intentions and behaviours as they relate to healthy eating and body weight from 2012 to 2019.

METHODS

LiveLighter® mass media campaigns, which are TV-led and aired statewide, depict genuine, graphic imagery of visceral fat around internal organs to raise awareness about the link between excess body weight and chronic diseases; demonstrate how unhealthy food and drink consumption can contribute to unhealthy weight gain; and recommend healthy alternatives. Cross-sectional telephone surveys were conducted at baseline and following each campaign phase with an independent, randomly selected sample of WA adults aged 25 to 49 years (n = 501 to n = 1504 per survey) to assess their knowledge of the link between excess body weight and chronic diseases, and their intentions and behaviours related to healthy eating and weight. Multivariable logistic regression models were undertaken to assess differences in responses between baseline and each post-campaign survey.

RESULTS

Compared to baseline, there were significant increases in the proportion of respondents reporting knowledge of excess body weight as a risk factor for certain cancers and type 2 diabetes, intentions to eat more fruit and vegetables and drink less sugar sweetened beverages (SSBs) in the next seven days, and the proportion of respondents who reported meeting guidelines for daily vegetable intake. Reported consumption of SSBs significantly decreased.

CONCLUSIONS

LiveLighter® is associated with improvements in knowledge of the health risks associated with excess body mass, increased vegetable intake and reduced SSB consumption in WA adults. These findings support the use of sustained, well-designed healthy lifestyle promotion and education programs as part of a comprehensive obesity prevention strategy.

Process evaluation of the Belgian one-month-without alcohol campaign 'Tournée Minérale': a mixed method approach

BACKGROUND

The Tournée Minérale campaign [TMC] is a mass media prevention campaign challenging Belgian adults to refrain from alcohol during one month. A process evaluation may help us better understand the effect of TMC and to formulate recommendations for future editions. The current study aimed to examine reach, experiences, perceived effectiveness and maintenance of TMC.

METHODS

A mixed method design was used to assess the process, using pre- and post-questionnaires (n = 49.022, 44.5 ± 13.1 years old, 37.0% men) and focus groups (n = 31, 47.3 ± 14.3 years old, 33.3% men).

RESULTS

Most campaign materials were considered useful and/or motivating. Facilitators for taking part in TMC were connectedness with other participants, stimulus control (e.g. removing alcohol at home) and a supportive social environment. Most difficulties were encountered with abstaining during social occasions as participants had to change a habit or find alternative non-alcoholic beverages. Participants reported both beneficial (e.g. sleeping better) and adverse effects (e.g. drinking more soft drinks).

CONCLUSIONS

Future editions of TMC should try to decrease perceived adverse effects (e.g. by providing attractive non-alcoholic beverages) and can benefit from having a forum where people can share experiences.

How to save a life: Public awareness of a national mass media take home naloxone campaign, and effects of exposure to campaign components on overdose knowledge and responses

BACKGROUND

Take home naloxone (THN) programmes are effective at reducing opioid related mortality, but require high levels of distribution, including to the general public. Mass media campaigns can be effective in improving public understanding of a topic and encouraging behavior change. Whilst mass media campaigns focusing on naloxone have been developed internationally, there is a lack of research on their potential impact. We investigated the effects of components of a recent national mass media campaign (Scotland, UK) designed to improve public awareness of drug related deaths, and readiness to intervene.

METHODS

We undertook a cross-sectional online experimental study with a randomized design, conducted with a nationally representative sample. Participants (N = 1551; 52.6% female; age 46.1±16.5 years) were assessed on overdose knowledge and readiness to intervene after presentation of eight combinations of campaign components.

RESULTS

Compared to a basic campaign description, exposure to all types of campaign component were associated with higher overdose knowledge (p < .001), but not knowledge of what to do in response to an overdose (p = .374), or readiness to intervene (p= .286). The greatest effects were associated with a media rich audio-visual resource (animated video with a popular song on the soundtrack, and narrated by a well-known actor).

CONCLUSION

Our data suggest that harm reduction is an appropriate topic for large-scale mass media campaigns. However, effects may be limited to knowledge and awareness raising in the general public, and may be related to the types of media used. Audience segmentation is important and more general messaging about drug related deaths may be more appropriate for the majority of audiences.

Impact of the first year of the "This girl can" physical activity and sport mass media campaign in Australia

INTRODUCTION

Addressing gender inequalities in physical activity is an important public health goal. A major campaign, 'This Girl Can' (TGC) was conducted by Sport England from 2015, and TGC was licenced in 2018 by VicHealth in Australia for development and use in a 3-year mass media campaign. The campaign was adapted through formative testing to Australian conditions and implemented within the state of Victoria. The purpose of this evaluation was to assess the initial population impact of the first wave of the TGC-Victoria.

METHODS

We assessed campaign impact using serial population surveys, with the target population being women living in Victoria who were not meeting the current physical activity guidelines. Two surveys were carried out before the campaign (October 2017 and March 2018), and the post-campaign survey immediately following the first wave of TGC-Victoria mass media (May 2018). Analyses were primarily on the cohort sample of 818 low-active women followed across all three surveys. We measured campaign effects using campaign awareness and recall, and self-report measures of physical activity behaviour and perceptions of being judged. Changes in perceptions of being judged and in reported physical activity were assessed in relation to campaign awareness over time.

RESULTS

Overall, TGC-Victoria campaign recall increased from 11.2% pre-campaign to 31.9% post-campaign, with campaign awareness more likely among younger and more educated women. There was a slight increase of 0.19 days in weekly physical activity following the campaign. Feeling that being judged was a barrier to physical activity declined at follow up, as did the single item perceptions of feeling judged (P < 0.01). Feeling embarrassed decreased, and self-determination increased, but exercise relevance, theory of planned behaviour and self-efficacy scores did not change.

CONCLUSIONS

The initial wave of the TGC-Victoria mass media campaign showed reasonably high levels of community awareness and encouraging decreases in women feeling judged whilst being active, but these did not yet translate into overall physical activity gains. Further waves of the TGC-V campaign are in progress to reinforce these changes and further influence the perception of being judged among low-active Victorian women.

Development and evaluation of a social marketing campaign to address methamphetamine use in Los Angeles County

Background

This study describes the development and impact of a social marketing campaign in early 2020 intended to prevent and reduce methamphetamine use in Los Angeles County (LAC). We used social marketing principles and the transtheoretical model to design the campaign, which was intended to avoid stigmatization of methamphetamine users and communicate compassion, empathy, and support.

Methods

To evaluate its impact, we collected cross-sectional online survey data post-campaign (n = 1,873) from LAC residents in population segments considered higher risk for methamphetamine use. We examine associations between campaign exposure and outcomes using bivariate analyses and binary logistic regression models, which control for the impact of the COVID-19 pandemic on methamphetamine use or likelihood of use.

Results

The analyses revealed that campaign exposure was associated with having more negative attitudes toward methamphetamine, calling LAC’s substance abuse service helpline, using methamphetamine fewer days, and considering abstaining. Frequency of exposure to campaign advertisements was positively associated with calling the helpline, suggesting a campaign dose effect. COVID-19-related factors were associated with using methamphetamine in the past 30 days.

Conclusions

Social marketing campaigns hold promise for impacting methamphetamine prevention and cessation behaviors. This study adds to the limited literature on mass marketing interventions to address this major health issue.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14180-y.

Economic evaluation of physical activity mass media campaigns across the globe: a systematic review

Background

Physical activity mass media campaigns can deliver physical activity messages to many people, but it remains unclear whether they offer good value for money. We aimed to investigate the cost-effectiveness, cost-utility, and costs of physical activity mass media campaigns.

Methods

A search for economic evaluations (trial- or model-based) and costing studies of physical activity mass media campaigns was performed in six electronic databases (June/2021). The authors reviewed studies independently. A GRADE style rating was used to assess the overall certainty of each modelled economic evaluation. Results were summarised via narrative synthesis.

Results

Twenty-five studies (five model-based economic evaluations and 20 costing studies) were included, and all were conducted in high-income countries except for one costing study that was conducted in a middle-income country. The methods and assumptions used in the model-based analyses were highly heterogeneous and the results varied, ranging from the intervention being more effective and less costly (dominant) in two models to an incremental cost of US$130,740 (2020 base year) per QALY gained. The level of certainty of the models ranged from very low (n = 2) to low (n = 3). Overall, intervention costs were poorly reported.

Conclusions

There are few economic evaluations of physical activity mass media campaigns available. The level of certainty of the models was judged to be very low to low, indicating that we have very little to little confidence that the results are reliable for decision making. Therefore, it remains unclear to what extent physical activity mass media campaigns offer good value for money. Future economic evaluations should consider selecting appropriate and comprehensive measures of campaign effectiveness, clearly report the assumptions of the models and fully explore the impact of assumptions in the results.

Review registration

https://bit.ly/3tKSBZ3

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01340-x.

Mass media campaigns for the promotion of oral health: a scoping review

Background

Oral diseases are highly prevalent globally and are largely preventable. Individual and group-based education strategies have been dominant in oral health promotion efforts. Population-wide mass media campaigns have a potentially valuable role in improving oral health behaviours and related determinants. This review synthesises evidence from evaluations of these campaigns.

Methods

A systematic search of major databases was undertaken to identify peer-reviewed articles reporting the evaluation of mass reach (non-interpersonal) communication strategies to address common forms of oral disease (i.e., dental caries, periodontitis, gingivitis). Studies using all types of quantitative design, published in English between 1970 and 2020 were included. Data concerning campaign objectives, content, evaluation methods and findings were extracted.

Results

Eighteen studies were included from the 499 identified through searching, reporting the findings of 11 campaign evaluations. Two of these used controlled quasi-experimental designs, with the remainder using pre- and post-test (N = 5) or post-test only designs (N = 4). Message recall, as a measure of exposure, was reported in eight campaigns with short-term (≤ 8 weeks) recall ranging from 30 to 97%. Eight studies examined impacts upon oral health knowledge, with four of the five measuring this at baseline and follow-up reporting improvements. From the eight studies measuring oral health behaviours or use of preventative services, six that compared baseline and follow-up reported improvements (N = 2 in children, N = 4 in adults).

Conclusion

There are relatively few studies reporting the evaluation of mass media campaigns to promote oral health at the population level. Further, there is limited application of best-practice methods in campaign development, implementation and evaluation in this field. The available findings indicate promise in terms of achieving campaign recall and short-term improvements in oral health knowledge and behaviours.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02212-3.

Testing Communication Concepts on COVID-19 Contact Tracing Among Black and Latinx/Hispanic People in the United States

OBJECTIVE

Black and Latinx/Hispanic people were more than twice as likely to die from COVID-19 than White people, but because of legacies of discrimination and maltreatment in health care, were less likely to participate in some public health responses to COVID-19, including contact tracing. This study aimed to test three communication campaign concepts to engage Black and Latinx/Hispanic people in contact tracing efforts.

METHODS

Twelve focus group discussions with 5 to 10 participants each were conducted online among participants from Black and Latinx/Hispanic urban populations in Philadelphia and New York state. Participants provided sociodemographic information and were presented with potential campaign concepts and prompted to rate the concepts and engage in open-ended discussion. For rating and sociodemographic data, chi-square tests were performed. For open-ended discussion data, a thematic analysis approach was used.

RESULTS

Across groups, the campaign concept that was rated most likely to encourage cooperation with contact tracing efforts was "Be the One," with 45% of total first-place votes. Participants expressed that the campaign caught their attention (79%), motivated them to engage with contact tracers (71%) and to talk to others about contact tracing (77%). Discussions also elucidated: the importance of community engagement; the need for clearer explanations of contact tracing; the preference for already trusted, community-based contact tracers; the need to reassure people about confidentiality; and for contact tracing to be culturally competent and empathetic.

CONCLUSIONS

This study highlights how strategic, culturally sensitive communication can buttress current and future contact tracing efforts, especially among Black and Latinx/Hispanic people.

Which is the best communication strategy, based on anti-tobacco ads, to impress teenagers? A multicenter cross-sectional study

BACKGROUND

Well-planned mass-media campaigns can increase health literacy and raise awareness about the consequences of tobacco use. This study aims to evaluate the emotions and opinions of adolescents about several anti-tobacco spots delivered by the mass media over the world.

STUDY DESIGN

Cross-sectional study.

METHODS

The study was conducted in Italy in 2016-2017 among students aged 13-17 years. Students expressed their emotions and opinions about seven anti-tobacco spots from all over the world on different topics and styles.

RESULTS

499 students attended. The video "Sponge" was found to be the most impressive (30.2%) and what they would have chosen if they had been responsible for campaign launched by the Minister of Health (40.5%). The "Icons" spot ranged second, with 19.2% and 17.4%, respectively.

CONCLUSIONS

In summary, this study showed that the communication strategies most effective, according to the students interviewed, are those that give clear messages with a scientific profile or that discover the false stereotypes, as in the video "Icons". However, further research is needed to investigate the effectiveness of TV campaigns against smoking, in terms of habits and knowledge in young people.

Developing a Mass Media Campaign to Promote Mammography Awareness in African American Women in the Nation's Capital

This study developed and examined the reach and impact of a culturally appropriate mass media campaign pilot, designed to increase awareness about the importance of mammography screening and the available community mammography services for low-income African American women ages 40 and above. We conducted formative research using focus groups to inform campaign development, resulting in five emergent themes-good breast health, holistic views of healthiness, cancer fatalism, fear of mammogram machines, and mammogram affordability. The campaign targeted specific low-income African American communities in the District of Columbia via print ads in Metro stations and on buses, print ads in the Washington Informer, and online ads on a local TV network website. Data were collected before, during, and after campaign implementation to assess reach and impact. Reach was measured by number of impressions (number of people exposed to the campaign), while impact was assessed via online ad click-through rates, website use and referrals, and mammography center calls. The campaign was successful in reaching the target audience, with a total combined reach from all media of 9,479,386 impressions. In addition, the mammography center received significant increases in new website visitors (1482 during the campaign, compared to 24 during the preceding period) as well as 97 calls to the dedicated phone line. Further research involving a more long-term investment in terms of funding and campaign run time, coupled with a more robust evaluation, is needed to assess if culturally appropriate mass media campaigns can generate increased mammography screening rates and decrease breast-cancer-related mortality.

Estimating the Pathways of an Antitobacco Campaign

PURPOSE

This study examined mechanisms through which the truth campaign, a national mass media antismoking campaign, influences smoking-related attitudes, and progression of tobacco use over time in youth and young adults.

METHODS

Structural equation modeling tested causal pathways derived from formative research and behavioral theory with a nationally representative longitudinal sample of 15-21-year-olds (n = 8747) over 24 months. Data were collected from 2014 to 2016, and analyses were conducted in 2017.

RESULTS

Greater ad awareness predicted strengthening of attitudes targeted by the campaign (i.e., feelings of independence from tobacco, antitobacco industry sentiment, decreasing acceptance of social smoking, and decreasing acceptance of smoking imagery), and attitude changes were significantly associated with greater support for an antitobacco social movement (e.g., agreement to the item "I would be part of a movement to end smoking"). Greater social movement support predicted a slower rate of progression on smoking intensity after two years of the campaign.

CONCLUSIONS

Findings suggest that engaging youth and young adults in a cause-based social movement for promoting health can be a powerful strategy to drive positive behavior change. Messages targeting attitudes that resonate with values important to this age group, including independence and connectedness, are particularly effective. Investments in national antitobacco public education campaigns are key policy interventions which continue to help prevent tobacco use among youth and young adults.

From awareness to behaviour: Testing a hierarchy of effects model on the Australian Make Healthy Normal campaign using mediation analysis

The Make Healthy Normal mass media campaign was a three-year campaign launched in 2015 in New South Wales (NSW), Australia to address community norms around overweight and obesity. It was underpinned by a hierarchy of effects model; a commonly used framework in campaigns but one that has rarely been tested. The campaign evaluation included a cohort study of NSW adults, surveyed three times over 12 months (n = 939 at Wave 3). This study tested the campaign's hierarchy of effects model, which theorized that participants would move from recognition to behaviour change via understanding, knowledge, attitude, social norms, self-efficacy, and intention, using these data. We used the moderation and mediation of effects method proposed by Baron and Kenny, adjusting for age and sex, to test for progression through the hierarchy of effects for two outcomes: physical activity and fast food consumption. We found a clear progression through the theorized model, from recognition through to behaviour change, via the intermediate variables for both outcomes. We also found several effects not predicted by the theorized model, with consistently strong associations between understanding and attitude, understanding and self-efficacy, attitude and self-efficacy, and self-efficacy and behaviour change in both outcome models. Our study provides support for the hierarchy of effects as a conceptual model in campaign planning and evaluation of social marketing campaigns. To our knowledge, this is the first study to compare the hierarchy between two behavioural outcomes and the consistency observed between the models adds to the potential usefulness of the hierarchy of effects.

Impact of the Make Healthy Normal mass media campaign (Phase 1) on knowledge, attitudes and behaviours: a cohort study

OBJECTIVE

To determine the impact of the first phase of the Make Healthy Normal mass media campaign on NSW adults' active living and healthy eating knowledge, attitudes, intentions and behaviour.

METHODS

Cohort design with NSW adults, followed up three times over 12 months, with n=939 participants completing all three waves. We used generalised linear mixed models to examine campaign awareness, knowledge, attitudes, intentions and behaviours over time.

RESULTS

Campaign recognition built to a reasonable level (45% at Wave 3), although unprompted recall was low (9% at Wave 3). There were significant increases in knowledge of physical activity recommendations (46% to 50%), the health effects of obesity (52% to 64%), and weight loss benefits (53% to 65%), with stronger effects in campaign recognisers. Conversely, we found declines in self-efficacy and intention to increase physical activity (39% to 31%) and decrease soft drink consumption (31% to 24%).

CONCLUSIONS

Overall, there are some positives for the campaign but intentions need to be a focus of future campaign phases. Continued investment over the medium- to long-term is needed.

IMPLICATIONS

Mass media campaigns can play a role in obesity prevention but robust evaluations are needed to identify the characteristics of effective campaigns.

Effectiveness of a Mass Media Campaign on Oral Carcinogens and Their Effects on the Oral Cavity

Objective:

To develop a mass media campaign on oral carcinogens and their effects on the oral cavity in order to increase awareness among the general population.

Methods:

Documentary and public service announcements highlighting the effects of tobacco and its products were designed and developed based on principles of behavior change. A questionnaire, designed to determine the knowledge, attitude and practice of people regarding oral carcinogens, was used to conduct a baseline survey at various sites in eastern Nepal. Local television channels and radio stations broadcasted the documentary and public service announcements. An evaluation survey was then performed to assess the effectiveness of the campaign.

Results:

Baseline and evaluation surveys covered 1,972 and 2,140 individuals, respectively. A third of the baseline population consumed quid, 22% chewing tobacco, 16% gutka (commercial preparation of arecanut, tobacco, lime and chemicals) and 25% cigarettes. Tobacco consumption differed significantly between 3 ecologic regions with greater use in the Terai region. The knowledge prevalence regarding the oral carcinogens quid (70%), chewing tobacco (82%), gutka (58%) and cigarettes (93%) significantly increased in the evaluation population. Females were more aware about the various tobacco products and their effects on health. More people knew about the harmful effects of tobacco on their health and oral cavity, and had their mouth examined and the frequency of consumption of these products reduced significantly after the campaign. Attitudes towards production, sale and advertisements of tobacco also improved significantly.

Conclusions:

The mass media campaign was an effective tool for increasing awareness among the population.

The impact of TV mass media campaigns on calls to a National Quitline and the use of prescribed nicotine replacement therapy: a structural vector autoregression analysis

AIMS

To estimate (1) the immediate impact; (2) the cumulative impact; and (3) the duration of impact of Scottish tobacco control TV mass media campaigns (MMCs) on smoking cessation activity, as measured by calls to Smokeline and the volume of prescribed nicotine replacement therapy (NRT).

DESIGN

Multivariate time-series analysis using secondary data on population level measures of exposure to TV MMCs broadcast and smoking cessation activity between 2003 and 2012.

SETTING AND PARTICIPANTS

Population of Scotland.

MEASUREMENTS

Adult television viewer ratings (TVRs) as a measure of exposure to Scottish mass media campaigns in the adult population; monthly calls to NHS Smokeline; and the monthly volume of prescribed NRT as measured by gross ingredient costs (GIC).

FINDINGS

Tobacco control TVRs were associated with an increase in calls to Smokeline but not an increase in the volume of prescribed NRT. A 1 standard deviation (SD) increase of 194 tobacco control TVRs led to an immediate and significant increase of 385.9 [95% confidence interval (CI) = 171.0, 600.7] calls to Smokeline (unadjusted model) within 1 month. When adjusted for seasonality the impact was reduced, but the increase in calls remained significant (226.3 calls, 95% CI = 37.3, 415.3). The cumulative impact on Smokeline calls remained significant for 6 months after broadcast in the unadjusted model and 18 months in the adjusted model. However, an increase in tobacco control TVRs of 194 failed to have a significant impact on the GIC of prescribed NRT in either the unadjusted (£1361.4, 95% CI = -£9138.0, £11860.9) or adjusted (£6297.1, 95% CI = -£2587.8, £15182.1) models.

CONCLUSIONS

Tobacco control television mass media campaigns broadcast in Scotland between 2003 and 2012 were effective in triggering calls to Smokeline, but did not increase significantly the use of prescribed nicotine replacement therapy by adult smokers. The impact on calls to Smokeline occurred immediately within 1 month of broadcast and was sustained for at least 6 months.

Effectiveness of media awareness campaigns on the proportion of vehicles that give space to ambulances on roads: An observational study

Background and Objective:

The findings of the Health Care in Danger project in Karachi suggests that there is presence of behavioral negligence among vehicle operators on roads in regards to giving way to ambulances. A mass media campaign was conducted to raise people’s awareness on the importance of giving way to ambulances. The main objective of this study was to determine the effectiveness of the campaign on increasing the proportion of vehicles that give way to ambulances.

Methods:

This was a quasi-experimental study that was based on before and after design. Three observation surveys were carried out in different areas of the city in Karachi, Pakistan before, during and after the campaign by trained observers who recorded their findings on a checklist. Each observation was carried out at three different times of the day for at least two days on each road. The relationship of the media campaign with regards to a vehicle giving space to an ambulance was calculated by means of odds ratios and 95% confidence intervals using multivariate logistic regression.

Results:

Overall, 245 observations were included in the analysis. Traffic congestion and negligence/resistance, by vehicles operators who were in front of the ambulance, were the two main reasons why ambulances were not given way. Other reasons include: sudden stops by minibuses and in the process causing obstruction, ambulances not rushing through to alert vehicle operators to give way and traffic interruption by VIP movement. After adjustment for site, time of day, type of ambulance and number of cars in front of the ambulance, vehicles during (OR=2.13, 95% CI=1.22-3.71, p=0.007) and after the campaign (OR=1.73, 95% CI=1.02-2.95, p=0.042) were significantly more likely give space to ambulances.

Conclusion:

Mass media campaigns can play a significant role in changing the negligent behavior of people, especially when the campaign conveys a humanitarian message such as: giving way to ambulances can save lives.

Ability of a mass media campaign to influence knowledge, attitudes, and behaviors about sugary drinks and obesity

OBJECTIVE

We examined the impact of a mass media campaign that was designed to educate residents about the amount of added sugars in soda and other sugary drinks, as well as the health impacts of consuming such drinks.

METHOD

The campaign was implemented in Multnomah County (Portland), Oregon in 2011 and included paid and unpaid media on the web, television, billboards, and transit. A telephone survey (n=402) measured campaign awareness, attitudes toward obesity, knowledge about health problems of excessive sugar, and behavioral intentions and behaviors around soda and sugary drink consumption.

RESULTS

Nearly 80% of people who were aware of the media campaign intended to reduce the amount of soda or sugary drinks they offered to a child as a result of the campaign ads. Those who were aware of the campaign were more likely to agree that too much sugar causes health problems (97.3% vs. 85.9%). There was no significant change in self-reported soda consumption.

CONCLUSION

Media campaigns about sugary drinks and obesity may be effective for raising awareness about added sugars in beverages, increasing knowledge about health problems associated with excessive sugar consumption, and prompting behavioral intentions to reduce soda and sugary drink consumption.