title: Engaging Minority Youth in Diabetes Prevention Efforts Through a Participatory, Spoken-Word Social Marketing Campaign.
abstract: OBJECTIVE
  To examine the reach, efficacy, and adoption of The Bigger Picture, a type 2 diabetes (T2DM) social marketing campaign that uses spoken-word public service announcements (PSAs) to teach youth about socioenvironmental conditions influencing T2DM risk.
  
  
  METHODS
  A nonexperimental pilot dissemination evaluation through high school assemblies and a Web-based platform were used.
  
  
  METHODS
  The study took place in San Francisco Bay Area high schools during 2013.
  
  
  METHODS
  In the study, 885 students were sampled from 13 high schools.
  
  
  METHODS
  A 1-hour assembly provided data, poet performances, video PSAs, and Web-based platform information. A Web-based platform featured the campaign Web site and social media.
  
  
  METHODS
  Student surveys preassembly and postassembly (knowledge, attitudes), assembly observations, school demographics, counts of Web-based utilization, and adoption were measured.
  
  
  METHODS
  Descriptive statistics, McNemar's χ2test, and mixed modeling accounting for clustering were used to analyze data.
  
  
  RESULTS
  The campaign included 23 youth poet-created PSAs. It reached >2400 students (93% self-identified non-white) through school assemblies and has garnered >1,000,000 views of Web-based video PSAs. School participants demonstrated increased short-term knowledge of T2DM as preventable, with risk driven by socioenvironmental factors (34% preassembly identified environmental causes as influencing T2DM risk compared to 83% postassembly), and perceived greater personal salience of T2DM risk reduction (p < .001 for all). The campaign has been adopted by regional public health departments.
  
  
  CONCLUSIONS
  The Bigger Picture campaign showed its potential for reaching and engaging diverse youth. Campaign messaging is being adopted by stakeholders.
authors.affiliation: 1 Departments of Internal Medicine and Pediatrics, and the Department of Medicine's Applied Clinical Research Program, University of Minnesota, Minneapolis, Minnesota.|2 Departments of Internal Medicine and Pediatrics, University of California, San Francisco, California.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rogers
authors.affiliation: 3 Division of General Internal Medicine and Center for Vulnerable Populations at San Francisco General Hospital, University of California, San Francisco, California.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Fine
authors.affiliation: 4 Department of Epidemiology and Biostatistics and Center for Vulnerable Populations at San Francisco General Hospital, University of California, San Francisco, San Francisco General Hospital and Trauma Center, San Francisco, California.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Handley
authors.affiliation: 5 Youth Speaks, San Francisco, California.
authors.forename: Hodari B
authors.initials: HB
authors.lastname: Davis
authors.affiliation: 5 Youth Speaks, San Francisco, California.
authors.forename: James
authors.initials: J
authors.lastname: Kass
authors.affiliation: 3 Division of General Internal Medicine and Center for Vulnerable Populations at San Francisco General Hospital, University of California, San Francisco, California.
authors.forename: Dean
authors.initials: D
authors.lastname: Schillinger
mesh_terms: D000293:Adolescent; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000517:prevention & control*; D004777:Environment; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008913:Minority Groups; D012495:San Francisco; D040241:Social Marketing
keywords: Health focus: prevention and health literacy; Outcome measure: cognitive, descriptive; Research purpose: program evaluation; Setting: Web-based platform, school; Strategy: education; Study design: nonexperimental; Target population age: youth; Target population circumstances: income level, geographic location, race/ethnicity; Type 2 Diabetes Mellitus, Prevention, Adolescent, Social Marketing, Health Campaigns, Health Literacy, Prevention Research. Manuscript format: research