Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action

Key action area 4: Encourage people to improve their levels of physical activity and healthy eating through comprehensive and effective social marketing

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Effective and coordinated social marketing campaigns are needed to increase physical activity levels and improve eating habits. These campaigns should inform, encourage and motivate individuals and families to make changes to their lifestyles.

The best evidence on the effectiveness of social marketing campaigns indicates that long-term, well-funded, sustained campaigns underpinned by qualitative research are necessary to achieve behaviour change. Compelling evidence from areas such as tobacco control, drink driving/road safety, immunisation, sun protection and HIV/AIDS, as well as the commercial sector, shows that appropriately targeted investment in social marketing can provide health and economic gains across populations.[125-128] Lessons from these campaigns are transferable to obesity management and prevention.

The Go for 2&5 campaign in Western Australia, conducted between 2002 and 2005, comprised a comprehensive range of strategies including mass media advertising, public relations events, a website, point-of-sale promotions, and school and community activities. Over the campaign period, awareness of dietary fruit and vegetable recommendations increased among the target audience of adults. In addition, there was an increase in population consumption of 0.2 servings for fruit and 0.6 servings for vegetables per day.[129]

Queensland Health has invested $4.4 million over 4.5 years (2005–10) in a statewide Go for 2&5 social marketing campaign strategy. Prior to the implementation of the campaign in 2005, adult consumption of fruit and vegetables was 3.5 serves per day, around half the recommended intake. Phase one increased fruit and vegetable consumption by an average 0.4 serves per person per day in the target age group in January–March 2006. Ongoing campaign tracking has shown a peak increase of 1.1 serves per person per day. Data suggests that recent price increases in fruit and vegetables and long off-air periods have eroded some of the gains in fruit and vegetable consumption. Final evaluation data will be available in mid-2010.[130]

The eventual evaluation of the Australian Government’s Measure Up campaign will provide valuable evidence in refining and targeting future communication strategies. Building on these campaigns at the state and territory and national level is essential to an effective approach.

Results demonstrate the importance of extended periods of campaign implementation to sustain accompanying knowledge, intentions and behaviour changes. The importance of televised media campaigns broadcast at sufficient exposure levels over relatively frequent intervals in achieving population behaviour change has been clearly demonstrated for tobacco in decreasing population smoking levels. This research highlights the need for such campaigns to be ongoing to sustain population-level change.[131]

A significant challenge to the promotion of healthy eating and physical activity behaviours is the fact that advertising for energy-dense nutrient-poor (EDNP) products generally promotes behaviours that compete with public health recommendations and strengthen potentially negative or challenging behaviours.[132, 133] Even during a major national nutrition campaign, exposure to healthy fresh food advertising is likely to be much lower than that for unhealthy food, unless investment in social marketing is significantly increased. Data collection on food advertising undertaken in 2005, at the same time as the Go for 2&5 fruit and vegetable promotion was screened, showed fruit and vegetable advertisements to comprise 4.6% of total food advertisements during children’s viewing periods (as defined by the Children’s Television Standards). During the same period, high-fat, high-sugar food advertising comprised 81.5% of total food advertisements; the observed differences have significant implications for the impact of nutrition promotion campaigns.[134]

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Small changes can make a difference

Some studies have found that using an approach aiming at small changes (such as increasing daily walking) in a community setting has been effective in halting weight gain and in achieving weight loss. A ‘small changes’ approach has also been successful in increasing total physical activity, decreasing total energy intake, and halting or lowering excessive weight gain. It has been suggested that such approaches could thus be used to stop the rise in obesity while broader environmental and societal changes are made.[135]

Even small estimates of behavioural change associated with health programs can translate into significant impacts at the population level.[132] Research suggests that an additional 2000 steps daily is adequate to prevent weight gain in adults, increasing energy expenditure by around 100 kilocalories. This level of activity is achievable by most people through brisk walking for around 20 minutes.[135] Reducing energy intake by the same amount is equivalent to the consumption of one chocolate biscuit.


The Taskforce proposes that the NPA would work with Australian, state and territory governments to develop and implement a comprehensive, sustained social marketing strategy to increase healthy eating, physical activity and reduce sedentary behaviour. This strategy would build on existing campaigns, including Measure Up and state campaigns such as Go for 2&, Find Thirty and Go for Your Life. The key elements of these social marketing campaigns would include:
  • Sufficient frequency, reach and intensity of mass media components over time, accompanied by adequate funding
  • Fund media campaigns long term, at national and state level, on a par or potentially above what should be expended on tobacco to achieve this sustainability and level of impact – to ensure commercially realistic funding
  • Ensure mass media is accompanied by funded local programs and skills development at the local level
  • Implementation is repeated and broad, with scaled-up campaigns nationally, using above and below the line media that are sustainable and have impact beyond immediate timeframe
  • Place media for maximum reach among low SES groups and others at particular risk of overweight and obesity, including providing extra reach for the most socially disadvantaged groups and areas through, for example, further television, radio, outdoor, transit and other local advertising
  • Establish governance around social marketing activities and co-ordination of approaches – determine the overseeing role of the NPA in partnership with government and non-government sectors
  • Choose messages most likely to reduce prevalence in socially disadvantaged groups and provide extra reach to these groups
Action 4.1
Fund effective national social marketing campaigns to increase physical activity and healthy eating and reduce sedentary behaviour; and support people to make informed choices about their health.

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