The Commercials for The Heart Truth Campaign: Can We Stop "Raising Awareness" and Change the Environment Instead?

If you are a hard core Olympics watcher like I am, then you have probably been inundated with these Diet Coke commercials. They are so pretty...they have red hearts on the can...they are getting a lot of exposure during Primetime TV...and the goal is...WAIT- I have no idea what the goal is!
According to the commercial, the campaign is aiming to "raise awareness of heart health". Does this mean people should know that their heart could be healthy or unhealthy? Does this commercial give us all we need to create "awareness", or should we be directed to their website for more information? Are people supposed to do something to improve or change their current heart health status after watching?

This is the perfect example of a public health campaign that drives me crazy because it wastes valuable resources on unclear, unmeasurable, and ineffective goals.

For more information, I visited their website. Here I learned that: The Heart Truth is a national awareness campaign, sponsored by the National Heart, Lung, and Blood Institute, being embraced by millions who share the goal of better heart health for all women. The campaign not only warns women about heart disease, but it equips them to take action against risk factors.

Okay- so it sounds like the goal is to achieve better heart health for women. So that will require some actual change to achieve (e.g., increase healthy behaviors like exercise, improve treatment for heart disease, etc). However, the commercial (and most of the website) does not include a "Call to Action". A Call to Action is a clear indication of the action that you would like people to take after viewing your health communication materials. In order for people to make/change their current actions, you must do a lot more than "raise their awareness" of the problem. Awareness raising is simply an increase in knowledge. In addition to knowledge, actions/behaviors are influenced by several layers of factors. For example:

• Individual (e.g., does one feel like they are at risk for heart disease? They may not even think these commercials are applicable to them. Do they have a genetic risk?)
• Interpersonal (e.g., does their family support their wanting to make changes to reduce heart disease? Do family members provide child care so that women can exercise and attend doctors appointments?)
• **Environment ( This layer is so important! But is most frequently ignored by campaigns that are wanting to "raise awareness" among individuals. E.g., what if your neighborhood does not have grocery stores that sell affordable healthy food? What if your neighborhood isn't safe for exercise such as walking/bike riding? What if there is no affordable healthcare within the scope of the public transportation that you rely on for transit?)
• **Society/Policy (What if you do not have health insurance to cover the doctors and/or nutritionist visits that are outlined in the "Action Steps" on the campaign website?)

As you can see from the list above, I would argue that the most daunting barriers to heart health for women fall in the 3rd and 4th categories. However, we continually see campaigns focusing on changing individual knowledge about diseases. Has that ever worked in the past?! Was it enough to tell people that cigarettes were unhealthy? No- we had to look at the environment and policy issues. We had to increase the prices/tax on cigarettes and create smoke-free work places, etc. The same has been seen in alcohol prevention.

So this week when you are watching speed skating in Primetime and this adorable soda can with a heart comes on the screen...picture me rolling my eyes as I sit on the couch. Please- let's spend valuable resources on reducing the barriers that actually impede health. Let's think bigger!