Development and early implementation of the bigger picture, a youth-targeted public health literacy campaign to prevent type 2 diabetes

Elizabeth A. Rogers, Sarah Fine, Margaret A. Handley, Hodari Davis, James Kass, Dean Schillinger

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


The prevalence of type 2 diabetes is rapidly rising, especially among minority and low-income youth. There is an unmet need to engage youth in identifying solutions to reverse this trajectory. Social marketing campaigns and entertainment education are effective forms of health communication for engaging populations in health-promoting behaviors. Critical to curbing the epidemic is moving the diabetes conversation away from individual behavior alone and toward a socioecologic perspective using a public health literacy framework. The authors developed an academic-community partnership to develop, implement, and evaluate a type 2 diabetes prevention campaign targeting minority and low-income youth. The Bigger Picture campaign uses hard-hitting, youth-generated spoken-word messages around key environmental and social drivers of the type 2 diabetes epidemic. Campaign goals included promoting health capacity and civic engagement. This article focuses on the development and implementation of the campaign, including (a) rationale and theoretical underpinnings, (b) steps in campaign creation, (c) testing the campaign messaging, and (d) campaign dissemination and evaluation planning. A youth-created health communication campaign using a public health literacy framework with targeted, relevant, and compelling messaging appears to be a promising vehicle for reaching at-risk youth to increase knowledge of and attitudes about preventing type 2 diabetes, change social norms, and motivate participation in health-promoting initiatives.

Original languageEnglish (US)
Pages (from-to)144-160
Number of pages17
JournalJournal of Health Communication
StatePublished - Oct 25 2014

Bibliographical note

Funding Information:
The University of California San Francisco Diabetes Family Fund for Innovative Patient Care, Education and Scientific Discovery; National Institute on Minority Health And Health Disparities of the National Institutes of Health under Award Number P60MD006902; the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases for The Health Delivery Systems-Center for Diabetes Translational Research P30DK092924; AT&T, Metta Fund, and the Department of Public Health’s Shape Up San Francisco through the San Francisco General Hospital Foundation; The California Diabetes Program; S.D. Bechtel Jr. Foundation; Stephen Bechtel Fund; Alameda County Public Health Department, Nutrition Services with support from Public Health Institute; and the California Endowment. Elizabeth Rogers was supported by the University of California San Francisco Division of General Internal Medicine’s National Research Service Award institutional training grant (T32 HP19025). None of the views expressed in The Bigger Picture PSAs are those of the funders.

Publisher Copyright:
© 2014 Taylor and Francis Group, LLC.


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