Eat Smart to Play Hard (ESPH) is a six-week social marketing campaign in which the community collaborates to engage students, parents, teachers, school staff, and other stakeholders in a common goal to “Eat Smart” in order to “Play Hard.” This obesity prevention campaign specifically focuses on increasing fruit and vegetable consumption among 8–11-year-olds in both rural and urban schools. During the campaign, students receive an activity booklet “Fun Book” that guides them through healthy eating and physical activities at home with their families. They return their Fun Book to school each week to receive a stamp from their teacher for every completed activity in order to earn incentives and a medal.  ESPH coordinators hang promotional materials throughout the school and community to support the desired behavior. At the end of the six weeks, the campaign culminates in a fun day event where students and teachers celebrate their success while enjoying healthy eating and fun physical activity.

Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time

Intervention Type: Social Marketing, PSE Change

ESPH targets low-income elementary school students and their parents/caregivers at school and home, and specifically focuses on 8-11 year-olds in both rural and urban communities. While students are completing recipes and activities in their Fun Book at home, stamps from teachers, and the fun day occur at school. The campaign extends into the community by placing promotional materials where the target audience visits, including grocery stores, community and medical centers, state agencies, and more. ESPH has been implemented in 16 of the 33 counties of New Mexico with over 20,000 students and their families.

Setting: Community (Live), School (Learn), Retail (Shop/Eat), Other: Home

Target Audience: Elementary School, Parents/Mothers/Fathers

Race/Ethnicity: All, Special focus on Hispanic/Latino populations.

The core components of Eat Smart to Play Hard include displaying promotional materials for eight weeks, training teachers, introducing the game to students, collecting, stamping, and returning funbooks weekly, distributing incentives for playing, hosting a 45–90-minute fun day celebration for all students, displaying progress posters in classrooms, distributing weekly parent newsletters, and making weekly announcements.

ESPH was developed using the social marketing framework, including the four Ps of marketing (Product, Price, Place, Promotion), to produce a fun experience for children to eat more fruits and vegetables.  Each component was strategically designed to address the barriers, benefits, and values of the primary audience, so most components are not modifiable. The time allotment for the fun day and the level of participation from teachers to help students’ complete Fun Book activities can be modified if needed. Through the wide-spread and continuous call to action of the Food and Nutrition Service’s core nutrition messages chosen by the audience, ESPH helps create an environmental change in school, the surrounding community, and in the home. The campaign is designed to be intensive and supports healthy school initiatives along with other SNAP-Ed implementing agencies’ direct education programming.

The Eat Smart to Play Hard materials include:

• Student materials: Activity book “Fun Book” with bookmarks and stickers
• Reusable stamp for teachers
• Classroom progress poster
• Promotional banners
• Promotional posters
• Student incentives: activity book, backpack, magnet, beach ball, water bottle, medal
• Campaign guidebook with quick guides
• Parent introduction letter and weekly newsletters
• Videos

An annual cost of $10.54 per student (funbook, magnet, ball, backpack, water bottle, medal, bookmark, stickers, and newsletters), an annual cost of $2.73 for each classroom (classroom progress poster), a one-time cost of $4.89 for each classroom (reusable teacher stamp for passports), and a one-time cost of $252.32 for each school (reusable promotional posters and banners).

In 2014-2015 using a matched control design, the prevention research center’s evaluation team conducted baseline and follow-up surveys with three study groups consisting of three schools that received ESPH, a comparison group that included three schools receiving another SNAP-Ed program, and a control group comprised of three schools without SNAP-Ed programming . From baseline to follow-up, the mean number of servings of fruits and vegetables increased by 0.77 (p<.05) in the intervention group, 0.43 in the comparison group, and 0.42 in the control group. Among children who participated in ESPH, those who completed more than 75% of the funbook consumed 2.3 more servings per day of fruits and vegetables compared to those who completed less of the funbook. In 2016-17, a pre-post survey was distributed to 11 schools located in four counties across New Mexico. Survey results showed that among ESPH participants, the daily amount of fruits and vegetables eaten significantly increased from baseline to follow-up with a combined consumption of fruit and vegetables of more than one-half serving per day.

The following reports summarize the findings from the first two years for formative research:

• ESPH Focus Group Results: Phase 1
• ESPH Focus Group Results: Phase 2

Evidence-based Approach: Practice-tested

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

	Readiness and Capacity – Short Term (ST)	Changes – Medium Term (MT)	Effectiveness and Maintenance – Long Term (LT)	Population Results (R)
Individual	ST3	MT1
Environmental Settings
Sectors of Influence		MT12

• MT1a: Behavioral changes related to eating fruit
• MT1b: Behavioral changes related to eating vegetables
• ST3a: Intentions or setting goals to increase physical activity and leisure sport (general physical activity or leisure sport)
• MT12a: Number of local agencies that sponsor a discrete, locally defined social marketing campaign and the number of counties or boroughs where they conducted local campaigns
• MT12b: Number of total media impressions, by outlet type (television, radio, outdoor, transit) used in a social marketing campaign, by demographic segment and geographic area (SNAP-Ed eligible and all others)

ESPH evaluation materials include a multiple pass recall survey for outcome evaluation and an implementation survey.

Website: The Eat Smart to Play Hard website includes formative research results, campaign strategies, parent newsletters, and funbook recipes.

Contact Person:
Glenda Canaca, MD

Research Assistant Professor

505-272-4462

glcanaca@salud.unm.edu

eatsmart@salud.unm.edu