a fivestage model for sustaining a community campaign
TRANSCRIPT
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A Five-Stage Model for Sustaining a CommunityCampaign
RIM A E. RUDD
Department of Health and Social BehaviorHarvard School of Public Health
Cambridge, M assachusetts, USA
JEAN N E GOLDBERG
School of Nutrition Science and P olicy
Tufts University
Boston, M assachusetts, USA
WILLIAM DIETZ
Division of Clinical Nutrition
The Floating Hospital
New England Medical Center
Boston, M assachusetts, USA
T he Sisters Together, M ove M ore Eat Better pilot communication program
focuses on young Black women in three inner-city communities to encourageimproved nutrition and increased physical activity. T he design for Sisters Together
is based on an expansion of a public health campaign that combines social market -ing with community building e orts. T he pilot program design comprises ve
phases: design, promotion, demonstration, transfer, and sustained activity. The pro-
posed ve- stage model holds potential for increasing the life span of a campaign andcontributing to community building. Partnerships and coalition development
promise to maintain the campaign beyond t he limited budget period. This descrip-
tive article illustrates the elements of a hybrid model for the design of a communica-
tion program with examples from Sisters Together, Move More Eat Better, a pilot program currently in the last year of implementation.
Introduction
For more than two decades public health educators have successfully applied mar-
keting strategies to support public health education eV orts and to shape a wide
variety of campaigns (Ling, Franklin, Lindsteadt, & Gearon, 1993). However, in a
society that is inundated with messages, audience response is in¯uenced by both
length and intensity of exposure. Substantial time frames and hefty budgets are
The authors acknowledge the valuable contributions of K elley Chunn, m edia specialist ; N ellie
Knight, M.Ed., community educator and coordinator; Donna DeCaille, R. D., community nutritionist;
Jamell Walker, ScM ; Osula Rushing, ScM ; Alexander Mazard, M.D., ScM ; Karla English ; research
assistants; and all of the members of the Sisters T ogether Coalition. Sisters Together: Move More, Eat
Better is a Weight-Control Information Network Pilot P rogram. This work is su pported by the National
Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, contract
No. N01-DK -4-2203.
Address correspondence to Rima E. Rudd, Department of Health and Social Behavior, Harvard
Schoo l o f Public Health , 677 Hun tington Aven ue, Boston , MA 02115, US A. E-mail:
rrudd@ hsph.harvard.edu.
Journal of Health Communication, Volume 4, pp. 37-48, 1999
Copyright 1999 Taylor & FrancisÓ
1081-0730/99 $12.00 1 .00 37
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38 R. E. Rudd et al .
needed to support any focused eV orts to deliver and sustain messages. Unfor-
tunately, a social marketing approach oV ers a challenge to the resources generally
allotted to public health interventions (Walsh, Rudd, Moeykens, & Maloney, 1993).
Consequently, public health messages are outnumbered by many commercial sectorinterests that promote products and activities with unhealthful consequences. In
many instances, however, sophisticated public health messages provide the only
viable alternative to the pervasive commercials selling untoward health. New stra-
tegies are needed for launching and sustaining a health promoting community cam-
paign.Sisters T ogether, a pilot campaign designed to focus on obesity prevention
among young Black women residents of inner-city communities, oV ered an
opportunity to test a new strategy for a sustainable campaign. An advisory panel of
scholars and community activists, referred to as the Sisters T ogether team, devel-
oped a campaign strategy that would bring an important message into the com-
munity and garner the assistance of a wide variety of community agencies to sustain
both the message and activities that are needed to support it. This discussion
focuses on a ve-stage model for campaign development with illustrations from
Sisters Together implementation eV orts. The Sisters T ogether pilot program is in its
last year of implementation and outcomes are currently being evaluated.
Overview: Campaign Focus
Sisters T ogether is an obesity prevention pilot program created for young Blackwomen residents of three inner-city neighborhoods in Boston with a focus onhealthful eating practices and increased physical activity. Health promoting mes-
sages emphasize group action and bring attention to existing community resources.
In order to insure intensity of exposure to health promoting messages and to con -
tinue the eV orts beyond the limited campaign nding cycle, the Sisters T ogether
planning team focused on methods to sustain vital campaign messages and toincrease opportunities for community women to carry through with needed action.
The overall framework for the Sisters T ogether campaign has been drawn from
the ecological model that views patterned behavior as an outcome of multiple levelsof factors ranging from individual factors to public policy (M cLeroy & Bibeau,
1988). Campaign themes and activities for the pilot program were designed tosupport local resources through expanded availability of healthy foods, increased
use of existing programs, and augmented skills. Campaign promotional eV orts were
designed to support normative change through messages of healthful eating, positive
images of healthy ethnic foods, and positive images of active women. Demonstra -
tions were designed to both build skills and efficacy and to highlight local expertsand available programs.
If the Sisters Together eV ort was to move beyond the promotion of ideas anddemonstration activities, then various community-based agencies and organizations
would need to support Move More/Eat Better themes and activities. These com-
munity agencies could then sustain the campaign themes over time and institution -
alize changes that promote women’s health and support improved nutrition and
increased physical activity. The campaign challenge was to combine message
delivery with demonstration activities and, at the same time, to develop viable part -
nerships with local organizations and agencies. Consequently, the action plans for
the Sisters Together campaign were divided into ve stages : (1) development anddesign of campaign themes and strategies, (2) promotion of key themes, (3) demon
-
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Model for Sustaining a Community Campaign 39
strations to establish visibility in the community and viability with potential part-
ners, (4) transfer of activities and skills to partners, (5) work with partners to sustain
themes over time and help others replicate the campaign elsewhere.
Overview: Five-Stage Model
The ve-stage model focuses on the diV usion of a campaign strategy among key
organizations within a community that has the ability to support activities and
services for the target population. The benets of this model accrue to both thepopulation served and to the organizations that serve it through consistent mes-
sages, coordinated delivery, and expanded opportunities for action. Both Labonte
(1997) and Walter (1997) stress the value of a community development approach
and note the critical importance of forging partnerships to build appropriate
agendas and to determine respectful approaches to change. The ve-stage model
combines a campaign eV ort with community developm ent by strengthening net-
works and maximizing use of scarce resources.
The rst stage of the model species the dimensions of the campaign through
the use of well-established social marketing strategic guidelines (M anoV , 1980 ;
Novelli, 1990, Lefebvre & Rochlin, 1997) and community organizing techniques.Stage two, the campaign promotion phase, focuses on implementation of campaign
activities. The expanded ve-stage model includes two promotional eV orts rather
than one eV ort. The rst is the traditional message delivery component ; the second
is the promotion of local community resources. Stage three is the demonstration
phase. It is not always part of a communications campaign; however, when it isused, it serves to demonstrate the value or the ease of acting on the message. In this
model, the demonstration phase has a dual function. F irst, it provides opportunities
to build efficacy among members of the target population. Next, it provides exam-
ples to other agencies that might incorporate similar activities and promote the
same messages. Stage four is the transfer phase and, based on Rogers’ Di usion of
Innovations (1983), focuses on the transfer of skills, campaign activities, and
materials to community partners for adoption and adaptation. In the fth stage,partners are drawn together in a collaborative eV ort to sustain campaign eV orts. See
Figure 1.
Stage 1: Campaign Design and Development
Campaign design can be enriched by lessons from community development and
from social marketing. W hile marketing strategy was used to develop the work planfor the pilot program Sisters T ogether, community development considerations
shaped the formation of the planning group and informed the overall strategyleading to the ve-stage model. If, as Minkler contends, the public health mandate is
to help create the conditions for community groups to set their health agenda and
determine needed action steps, then public health programs must promote com-
munity building. The active engagement of community members in the design and
implementation of programs is one key aspect of such work (Minkler, 1997).
In the development of the Sisters T ogether pilot program, the contract man-
dated a focus on obesity prevention ; however, the decision to work with young
Black women was determined through interviews with community-based nutri-tionists and representatives from community health centers. Health professionals
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40 R. E. Rudd et al .
FIGURE 1 Five-Stage Model for Sustaining a Community Campaign.
were asked to identify where they saw the strongest need among the various popu-
lation groups they served and to suggest where new resources would be most wel-
comed. Their suggestions that program eV orts need to be addressed to young Black
women were supported by ndings from the 1990 Massachusetts Behavioral RiskFactor Survey indicated that the prevalence of obesity was 20%; that young obese
black women with reported annual incomes of less than $15,000 were at high risk
for health problem s ; that risk increased by urban address ; and that 5% of womenages 18 to 24 participate in regular exercise. These issues were being addressed in
the literature (Kumanyika, M orssink, & Agurs, 1992 ; Lewis, Raczynski, Heath,Levinson, Hilyer, & Cutter, 1993) and have been explored in more recent studies
(Airhihenbuwa, Kumanyika, Agurs, Lowe, Saunders, & M orssink, 1996 ; JeV ery &
French, 1996 ; Caldwell, Brownell, Wil¯ey, 1997 ; K umanyika, 1997). Overall, these
studies document the high prevalence of obesity among African American women,
the cultural factors associated with high fat diets, and issues related to physicalactivity. The choice of focus on young Black women for an obesity prevention cam-
paign was seen as appropriate.Consequently, once the campaign target population was identied as young
Black women, the size and composition of the initial group of program planners
immediately changed. Experts in media, education, and nutrition who also lived orworked in the community or both and were familiar with or part of the culture of
the target population were asked to become members of the pilot program planning
and implementation team. This crucial step of expanding the design/decision-
making team to actively engage members of the population of interest enabled the
pilot program team to set a strong foundation for community linkages and forcommunity building.
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Model for Sustaining a Community Campaign 41
The strategic planning techniques of m arketing shaped the team’s work plan
and set the agenda for the rst steps in campaign theme and message development.
Social marketing emphasizes the importance of research, design, evaluation, and
redesign as critical to the development of an eV ective campaign (Lefebvre & Flora,1988 ; Lefebvre & Rochlin, 1997). EV ective strategies are based on formative
research that includes an understanding of culture, gender, social class issues, atti-
tudes, and preferences. Initial research for the pilot program drew information from
three sources of data and used three methods to gather information related to Black
women and nutrition and, similarly, to Black women and physical activity.This technique, termed ‘‘triangulation,’’ is often used to conrm data. Findings
are strengthened when data from one source, uncovered by one method, or gathered
by one researcher are conrmed by data gathered by another mechanism (Becker,
1958). In addition to corroboration, however, triangulation also oV ers the possibility
of a more in-
depth understanding of issues as well as a grasp of various perspectiveson an issue (Miles & Huberman, 1994). The various sources of data, gathered by
diV erent methods, yielded insight into practices, preferences, and issues related to
nutrition and to physical activity.
Thus, initial research eV orts for the Sisters Together campaign included analysis
of existing survey data on the topic of prevention and treatment of obesity, liter-ature reviews on diet and weight-loss practices of minority populations, and explo-
rations of the target audience’s understanding of the link between disease and
obesity, knowledge of sources of fat in the daily diet, perceptions of barriers to
low-fat eating, use of food labeling, and perceptions of body weight and image. In
addition, health and communication experts were interviewed, Boston-based com-
munity nutritionists were surveyed, and a meeting was held with the Massachusetts
League of Community Health Centers. The information collected and insights gath-
ered were used to guide the development of message concepts and to prepare a focus
group moderator’s guide. Six focus groups with members of the target audience
were conducted to explore perceptions of health, healthy eating, physical activity,and credible sources of health information. The information gleaned from the
various sources led to the development of the overall themes for the campaign, the
formation of messages about healthy eating and physical activities, and ideas foractivities in support of these messages.
The themes, messages, and ideas for action were designed and then underwentrigorous and detailed testing with the target population. The campaign logo, for
example, combines a multilayered theme statement, Sisters Together: Move More
Eat Better, with a visual depiction of three women walking together. The language
derives from focus group discussions and was one of several combinations of theme
statements piloted and discussed in group and intercept interviews. A number of visuals were similarly tested, modied, and retested for many components including
number of women depicted, size and shape of the gures, hair style variations, andlogo color combinations. The nal logo has generated consistently positive reac-
tions. See Figure 2. Thus, formative research yielded a product that re¯ects the
language of the population and resonates with cultural themes of sisterhood andcollective action.
Throughout the program, the design of all new materials and activities were and
continue to be based on formative evaluations. The m ajor questions shaping for-
mative evaluation eV orts include the following :
the contents address key thematic issues, key information, and needed skills?n Do
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42 R. E. Rudd et al .
FIGURE 2
the design components re¯ect the culture and preferences of the target popu-n
Dolation ?the language and style appropriate and readable ?n Are
Stage 2: Promotion
Prom otion serves as the cornerstone of any campaign. Lessons from the commercial
sector point to the importance of message promotion through consistent repetitions
of themes for community saturation. The primary purpose of promotional activity
in Sisters Together is to convey the messages of healthy eating and physical activityto the target audience of Black women between the ages of 18-35 who live in theBoston neighborhoods of Roxbury, Dorchester, and M attapan. M edia promotion
has been used to communicate specic healthy eating and activity tips, help generate
attendance at events, and cross promote partners. Promotional activities include the
use of print and broadcast media- the use of local radio, TV, and print coverage or
previews through calendar/announcements or P SAs. These eV orts, combined withactive participation in neighborhood events designed to attract members of the
target population, brought the logo, messages, and materials to community women.
At these events, team members set up a table, display a banner, distribute materials,talk about the themes and key issues, and, nally, use the opportunity to encourage
women to sign up to participate in walking groups. On several occasions, partici-pation in such events enabled the team to discuss and pretest materials such as the
walking brochure and calendar menus. Sisters T ogether actively engaged in the
planning for and implementation of festivals, carnivals, professional association
meetings, sponsored family picnics, and walk-a-thons in support of community
agencies. At the outset of the campaign, these events provided Sisters Together withvisibility in the community.
In addition, Sisters T ogether staV compiled a mailing list from women whoattended any sponsored event in order to send out a monthly newsletter. A typical
newsletter includes an article highlighting the month’s theme, a review of one or two
recent events, a description of a partner organization, and a detailed calendar of events for women. For the duration of the funding cycle, Sisters T ogether presents
and continues to cosponsor monthly activities. Additional thematic messages are
delivered in the community through ¯yers, radio spots, and occasional feature arti-
cles in the major city and neighborhood newspapers.
The traditional marketing campaign design focuses on the four P s : product,promotion, placement, and price. Here, in the ve
-stage model, the promotion stage
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Model for Sustaining a Community Campaign 43
includes delivery of the campaign message as well as the promotion of local com-
munity programs and resources. These resources include existing health care and
social service organizations, private entrepreneurs, and small businesses. At this
important second stage, successful promotion begins to capture the attention of both the target audience and potential partners. Intercept interviews serving as
interim evaluations of Sisters Together indicated that community women at farmers’
markets and walking in the local parks recognize the logo and can repeat the cam-
paign theme. Early promotional eV orts did capture the attention of both the target
audience and potential partners.
Stage 3: Demonstrations
The third stage of the ve-stage model focuses on demonstrations of action steps
and activities. Demonstrations bring role models, oV
er illustrations of how to imple-
ment the general campaign messages, and provide activities to practice or engage in
action. Strategically placed demonstrations enable a campaign to serve as a vehicle
to increase use of existing programs or familiarize community members with facili-
ties that they had not visited before. The purposeful selection of demonstration
activities can be designed to garner partners and to in¯uence programming at thecommunity level. The demonstration phase of the Sisters T ogether campaign estab-
lished visibility within the community, oV ered evidence of concrete mechanisms to
promote the Move M ore Eat Bett er messages, and oV ered support to potential part-
ners. For example, the Sisters Together planning team mobilized a group of womento walk in a fund raising eV ort by a local organization.
Demonstrations focused on increased activity reinforced the concept that the
‘‘move more’’ component of the Sisters Together campaign symbolizes health pro-
moting action and simultaneously re¯ects the cultural traditions and preferences of
the target population. Activities have included a comprehensive structure for
walking groups and aerobic groups, including the development of a brochure forwalking, a training curricula for aerobic groups, as well as the formation of desig-
nated walking routes and scheduled walk sessions, indoor activities for the winter,
the promotion of existing and often underutilized community centers, and dis-
counted membership at the local YMCA as well as for private aerobic programs.
The nutrition component has included support for the development of a localcable television show W hat’s Cooking in the Neighborhood hosted by a local nutri-
tionist. The television program highlighted local chefs who demonstrated healthy
recipes available at their restaurants and who, in turn, promoted the shows in their
restaurants with table tents. A nutrition and tness calendar contained recipes based
on nutrition recommendations from the dietary guidelines and behavioral ideas forfood preparation and physical activity. The calendar was promoted over the local
radio station and at various meetings in the community. It was also given to SistersTogether partners and distributed to all w omen on the mailing list. The second
calendar included the names of all partner groups. Additional nutrition related
activities included discussion groups and seminars such as a book signing for anethnic cookbook, cooking demonstrations, m arket tours, and work with a local
organization to establish a supermarket to increase the availability of healthful
foods.
These visible demonstrations emphasize efficacy building and are designed to
include small achievable steps, incorporate role models, and support collectiveaction (Baranowski, P erry, & P arcel, 1997 ; Bandura, 1986). All of the activities were
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44 R. E. Rudd et al .
supported by a popular radio station disc jockey, an athlete and entrepreneur, a
dance instructor, and a health center nutritionist. P rocess evaluation measures
included exit interviews at events and follow-up phone interviews to assess percep-
tions as well as proximal outcomes such as intent to act and reported behaviorchanges. P rocess evaluations have included the traditional paper and pencil m ea-
sures used in exit interviews to assess participants’ reactions to programs and
events. Two waves of telephone interviews with members of Sisters Together serve
as baseline and midpoint evaluation measures for a nal analysis but have also
served to assess health related perceptions and to report change among members of the target population. Furthermore, intercept interviews with shoppers at farmers’
markets and with walkers in a local park have focused on questions pertaining to
program recognition as well as to reported change in eating or physical activity.
In-depth interviews with partners and coalition members assess perceptions of needs
and progress in terms of partnerships and coalition membership.F inally, weekly meetings have enabled the planning team to regularly review,
assess, and redirect program eV orts. The regular weekly meeting of the team pro-
vides an excellent forum for tracking a very complex set of activities : developing
materials, making decisions about participation in and coverage of community
events, designing and implementing a strategy for partnerships and resource expan -
sion, and monitoring and assessing activities.
The demonstrations enabled the Sisters T ogether planning group to develop
partnerships with local groups and service organizations. In addition, the Sisters
Together team began to coordinate events in the community by forging relation-ships among Sisters Together partners who had not worked together before.
Stage 4: Transfer
The fourth phase of the ve-stage planning model focuses on enabling community-
based groups and organizations to incorporate key themes into their own activitiesand program s. Transfer is the diV usion of innovation with community organizations
and the adoption and adaptation of the materials and activities that support cam -
paign themes. While some organizations may choose to adopt materials, messages,and themes, others will choose to modify or adapt key campaign elements to more
closely meet their own mission.The transfer phase of the Sisters T ogether campaign includes three separate
activities :
(1) the identication and establishment of partnerships based on mutual or overlap -
ping goals ;(2) active engagement with partner organizations in the community through
cosponsorship ;(3) shared use of logos, materials, and evaluation ndings.
The demonstrations in the third phase of the campaign set a strong foundation
to facilitate diV usion of themes, materials, and programs developed by Sisters
Together.
Potential partners were identied through a community mapping activity at the
program startup. This focus on existing resources, instead of on existing decits,
yielded potential partners (M cKnight & Kretzmann, 1997). A resource guide was
developed early in the campaign and listed all the places women might gather aswell as all the programs and organizations that serve women’s health interests. The
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Model for Sustaining a Community Campaign 45
planning team augmented traditional program listings of health centers, health and
exercise programs, and child care centers. Walking and driving tours of the com-
munity enabled team members to add beauty salons, churches, laundromats,
markets, and restaurants to the resource guide.P artners for Sisters T ogether had to meet established criteria : to address
women’s issues and concerns, have themes compatible with those of the Sisters
Together campaign, serve women in the communities of interest, and have a demon -
strated interest in promoting Black women’s health. Partnerships were established
with a rich assortment of individuals, businesses, community-based programs, andorganizations.
A variety of events have provided the opportunity for interaction with partners
and the start of the transfer phase of Sisters Together activities. For example, a disc
jockey began walking herself as she promoted the walking program and other activ-
ities related to the Sisters T ogether P SAs her station had agreed to air. SistersTogether walking programs used several partners’ sites as a starting or ending point
for walks. Demonstration aerobic programs and cooking demonstrations were
oV ered at sites that could continue such oV erings. Leadership training for walking
groups and for aerobic programs was oV ered to the staV of community organi-
zations.The long-term goal of the transfer process is to build a joint consumer-
professional coalition within the targeted communities to focus on women’s diet and
activity. Meetings with the staV of existing organizations were structured to
exchange information and to discuss partnership ideas. The focus of these dis-cussions was to determine interest in the Sisters T ogether campaign, in the joint
sponsorship of activities, in the use of current materials, and in the joint production
of materials. These individual meetings set the stage for formal partnerships. Part-
ners enjoyed access to materials that had been piloted with community women and
revised based on their preferences and recommendations, use of the Sisters Together
logo to promote events, and cosponsorship for key events. The newsletter, sent inwhite paper stock to partner groups, enabled some to repackage timely and inter-
esting notices. Others appreciated the listing and promotion of their key events.
Subsequently, interviews with those who had been partners over time helped theplanning team gather information about organizational goals and objectives,
planned activities, barriers to action, and current needs. A m eeting of all Sisters
Together partners to learn about interview ndings set the stage for coordinate
eV orts among partner organizations. The rst meeting was focused on developing
strategies for increasing the participation of community women and on enhancing
community capacity (Pilisuk, M cAllister, & Rothman, 1997). P artners scheduled
regular monthly meetings. This initial gathering led to the development of a Sisters
Together coalition.
This coalition has the potential to integrate the ‘‘move more, eat better’’ themesinto individual organizations and support the themes through a coordinated eV ort.
To realize this potential, however, all parties must focus attention on articulating
common interests and support and sustain collective action (Fisher, 1997). The pilotprogram team served a critical function by identifying materials and resources
needed by partners and helping the various member organizations plan quarterly
calendars and cosponsor activities. Currently, the coalition comprises seventeen
member groups and continues to meet and plan monthly. Over the course of the
past program year, all campaign activities were coordinated by the coalition andmost community
-based programs addressing nutrition, physical activity, or both
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46 R. E. Rudd et al .
among Black women were cosponsored by the Sisters T ogether Coalition. Events
include a yearly mother and daughter brunch, numerous health fairs, cooking
demonstrations, a winter long fun and tness program, dance programs, and com-
munity walks. Collaboratively developed materials include a coalition poster listingall partners and a brochure providing hair care tips for the active woman.
Stage 5: Sustained Activity / Replication
Sustainability must be at the heart of a successful campaign. If a campaign eV ort isto survive beyond initial funding, then themes and programs must be promoted and
continued by established organizations. The sustained activity phase of the model
must bring the campaign into the strategic planning eV orts of community-based
organizations.
The last phase of the Sisters Together campaign is addressing sustained eV
ort aswell as replication. Sustained eV orts focus on strengthening the existing coalition of
partner organizations. In this last year of assured funding, an entry level position for
a coalition staV person has been created and will be supported. The staV will focus
on coalition mailings, meeting agendas and minutes, and calendar building. Coali-
tion meeting sites rotate and the meetings themselves are facilitated by variousmembers in turn. Scheduled skill building sessions that are focused on evaluation
techniques and on proposal writing may enable the coalition to garner new funds.
The Sisters T ogether planning team is also engaged in evaluation activities.
Replication eV orts are supported by case analysis, discussions of delineated steps,and by evaluation ndings. Learning points, lessons learned, case illustrations, andevaluation ndings all enable other organizations to incorporate activities and pro-
grams developed as demonstration eV orts. Evaluations have been an essential com-
ponent of each of the campaign stages and include formative, process, and proximal
outcome measures. Formative evaluations included measures of the intent and eV ec-
tiveness of materials designed for the campaign. P rocess evaluations consideredwhether the process of the campaign, such as an event, has achieved the goals for
which it was designed. Outcome evaluations will incorporate measures that relate to
the success of the campaign or its elements in the achievement of the primary goalsof the campaign. These activities are currently underway and will include intercept
interviews in the community, phone interviews with women who have participatedin one or more events, and in-depth interviews with community-based agencies
(including partners).
Overall, evaluations and case study descriptions support replication eV orts.
However, the guiding assumption underlying this phase of work is that an innova -
tion must be conceptualized as relatively malleable. Organizations will modifyaspects of a product or process to t their established goals and objectives (Rogers
& Adhikarya, 1984). As long as key components of the campaign are carefully iden-
tied, there is ample room for partners to adapt rather than completely adopt a
campaign design. Evaluation activities for Sisters T ogether will examine ways in
which community organizations adopted or adapted campaign themes.
CONCLUSIONS
Like many social marketing products, public health products are new ideas, prac -
tices, and community-based action steps. These products, like those in the com-
mercial sector, must be well packaged, actively promoted, strategically placed, and
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Model for Sustaining a Community Campaign 47
reasonably priced. The public sector has borrowed liberally from the private sector
and has successfully designed strategic marketing campaigns. However, limited
funding continues to handicap the public sector and limit the length and intensity of
campaign eV orts. The proposed ve-stage model for sustaining a community cam-
paign moves beyond strategic design and promotion and oV ers a strategy for
extending the life and increasing the depth of a campaign eV ort.
The ve-stage m odel does not assume that a complete adoption of even the
most rigorously designed campaign will take place; rather it assumes that adapta -
tion is the rule. Dialogue and discussion with potential partners, contracts withpartners, and an openness to creative participatory processes can support and
enrich a community campaign. It is, however, incumbent upon the designers to
share research ndings and evaluation evidence and to delineate key themes and
highlight key ingredients. These themes and ingredients become the core com-
ponents of a¯
exible design. The ve-
stage model for sustaining a community cam-
paign oV ers a mechanism for expanding the life of a campaign.
References
Airhihenbuwa, C. O., Kumanyika, S., Agurs, T. D., Lowe, A., Saunders, D., & Morssink, C. B.
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