Who is this Program for?

Children between the ages of 13-19 years old are more susceptible for behavior changes and modifications. Peer influence is a driving force that has the potential to influence children on both positive and negative behavior changes. At this age, children are given more independence as they are now participating in full school days filled with extracurricular activities. This independence comes with more decision making responsibilities. For instance, what to eat for lunch. There are various options presented to them at the cafeteria along with vending machines packed with SSB. Nutrition education must be provided in an engaging and exciting way in order for students to be engaged. Social media will be this outlet.

Where will this program be located?

This program will occur at the school. To be the most effective with this target age group, this program will occur within the school facility to be accessible by all students without having to go out of their way. Our campaign’s physical location will take place inside a school building but will include multiple opportunities to engage students such as in the cafeteria and the common areas. The plan consists of making this program more effective by placing products strategically, such as placing SSBs behind non-SSB options in the cafeteria, and having cafeteria staff encourage water consumption by asking students if they have had water that day (Lee & Kotler, 2016). 

According to the NYTimes, TikTok classified more than a third of its 49 million daily users in the United States as being 14 years old or younger (Zhong & Frenkel, 2020). Additionally, 33% of Instagram users are in high school or younger and 61% of students in high school or younger are using Facebook. Therefore, utilizing social media to impact the students will be the best way to develop and implement this program. It will be essential to utilize school resources such as televisions that hang in common areas and promotion of social media occurs to encourage individuals to follow and like the posts. School based interventions have been proven successful, and utilizing social media to promote this program will be the more effective way to engage all students and encourage them to decrease SSB.

Identity levels of Influence

Based on research, the Social Cognitive Theory (SCT) to enhance our participants self-efficacy and improve the outcome of positive behavior change. The Social Cognitive Theory assumes that behavior is the outcome of interaction between cognitive processes and environmental events. The cognitive processes include expectations, self-efficacy, attitudes, beliefs, and values, which is stimulated by an individual’s environment (Wright, 2013).

Influence will be derived from both the community and individual level of the social-ecological model. The community in this scienero will be the school where the program will take place. The program will engage school staff to partner with the program and provide support and aid for the students. School policies will contribute to the effectiveness of the program as teachers will encourage students to engage in healthier lifestyle behaviors and promote the schools social media accounts. For most students, being at school may be the first time they are exposed to increased independence and responsibilities. The community level model will provide the needed support during this period of change. 

This program will influence the individual the most. This level will identify biological and personal history factors that would increase the child to be at a greater risk for obesity and chronic disease. Through the social media programs, students will have to reflect on their own lifestyle behaviors and food related decisions they make. Individuals will need to consider their age, health, family history, demographics, socioeconomic status and food consumption to better understand the need for behavior change. The goal with this program is that individuals will acknowledge the harms of SSB and change their lifestyle behaviors to better their overall health. Using both the community and individual level of the socio-ecological model this program has the potential to be effective. 

Students will most likely be in the precontemplation and contemplation stages of change. Many adolescents are not necessarily thinking about the future in regards to their health. It is important for them to understand the relationship between diet and chronic disease. 

Rationale for selection

Obesity rates are continuing to rise throughout the younger population. Increased obesity has been related to the increased risk of chronic diseases such as CVD and diabetes. The American Heart Association recently released a statement recommending reductions in added sugar intake to no more than 100-150 kcal per day for most Americans. The statement identified sugar sweetened beverages (SSB) as the primary source of added sugars in the American diet (Malik et al, 2010). The research between SSB consumption among adolescents has been conducted through several epidemiological studies and found a positive association between SSB intake and weight gain (0.08; 95% CI: 0.03, 0.13 kg). Concluding that increased SSB can contribute to obesity in the adolescent age group (Malik et al, 2010).

Research studies observed 36 interventions to verify the efficacy of school-based interventions aimed at reducing SSB consumption among adolescents. Twenty of the interventions focused on educational and behavior change. Ten focused on legislative and environment and 6 included both individual and environmental. Results showed them all to be equally effective, at decreasing SSB consumption among adolescents. This suggests that efforts to reduce availability and/or eliminate SSB in schools should be pursued.

Center for Disease Control and Prevention. Get the Facts: Sugar-Sweetened Beverages and Consumption. (2020, October 2). https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html. 
Kotler, P., & Lee, N. (2016). Social marketing : changing behaviors for good. University of Washington and Social Marketing Services, Inc., Philip Kotler, Kellogg School of Management. (Fifth edition.). SAGE.
Malik, V. S., Popkin, B. M., Bray, G. A., Després, J. P., & Hu, F. B. (2010). Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation, 121(11), 1356–1364. https://doi.org/10.1161/CIRCULATIONAHA.109.876185
Making health communication programs work: A planner’s guide. (2002). Bethesda, MD: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health.
Wright, K. B., Sparks, L., & O’Hair, H. D. (2013). Health Communication in the 21st Century,   Second Edition. John Wiley & Sons
Zhong, R., & Frenkel, S. (2020, August 14). A Third of TikTok’s U.S. Users May Be 14 or                                                       Under, Raising Safety Questions. Retrieved October 21, 2020, from https://www.nytimes.com/2020/08/14/technology/tiktok-underage-users-ftc.html