Buzz Agents in a Teen-Driven Social Marketing Campaign Positive Campaign Attitude Leads to Positive Changes in Health Outco

Case-Based Article
Buzz Agents in a Teen-Driven
Social Marketing Campaign:
Positive Campaign Attitude
Leads to Positive Changes
in Health Outcomes
Social Marketing Quarterly
2016, Vol. 22(3) 218-235
ª The Author(s) 2016
Reprints and permission:
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DOI: 10.1177/1524500416637052
smq.sagepub.com
Amy Struthers1 and Ming Wang1
Abstract
A research team in Nebraska developed a public health campaign for teens focused on obesity prevention, based on social marketing and buzz marketing principles, to test a series of hypotheses
postulating that positive attitude toward the campaign among the most engaged members of the target
audience, the buzz agents, will lead to positive attitudinal as well as positive self-reported behavioral
changes involving fruit and vegetable consumption and physical activity. The team implemented the
Whatcha doin? social marketing campaign in a select number of public high schools in Nebraska from
2007 to 2013. Results from 6 years of annual survey data of buzz agents in these schools showed
positive associations between attitude toward the campaign and changes in health attitudes and
behavior.
Keywords
buzz marketing, buzz agent, social marketing, health communication, teen wellness
Introduction
From 1971 to 2005, the obesity rates among U.S. adolescents aged 12–19 increased from 6.1% to
17.8%, according to the Centers for Disease Control and Prevention (CDC) National Health and
Nutrition Examination Survey (Ogden & Carroll, 2010). In response, government agencies and public
health officials at the federal, state, and local levels began searching for more innovative ways to
communicate persuasive messages of obesity prevention.
In the fall of 2006, a research partnership between the advertising faculty at a large Midwestern
university in the United States and the state’s Department of Health and Human Services (DHHS) was
formed to explore more effective ways of communicating public health messages that would address,
at the state level, this growing crisis of adolescent obesity. The collaboration evolved into a teen-driven
1
College of Journalism & Mass Communications, University of Nebraska–Lincoln, Lincoln, NE, USA
Corresponding Author:
Ming Wang, College of Journalism & Mass Communications, University of Nebraska–Lincoln, Lincoln, NE 68588, USA.
Email: [email protected]
Struthers and Wang
219
social marketing campaign, Whatcha doin?, implemented in 32 high schools across the state over a 6year period, funded by the CDC and jointly administered by state public health officials and the lead
author of this article.
The campaign utilized buzz agents, ordinary students from participating high schools, to engage
their peers in the promotion of fruit and vegetable consumption and physical activity. The rest of the
article first describes the application of buzz marketing in social marketing and its relevance to the
theoretical framework of this project. After that, the authors discuss the development of the campaign
using social marketing benchmarks. The article then details recruiting buzz agents and implementing
the campaign with the social marketing mix. Using 6 years of survey data, this study finds that buzz
agents’ positive attitude toward the campaign is largely associated with improved health attitudes and
behaviors. This article concludes with a discussion of the lessons learned from engaging buzz agents
and the issue of scaling up the campaign.
Applying Buzz Marketing to Social Marketing
Buzz Marketing and Its Application in Social Marketing
Among young adult consumers, research indicates both a lack of interest in messages concerning
health and nutrition and a reliance on trusted family members and friends as information sources
(Brennan, Dahl, & Eagle, 2010). Buzz marketing, as a carefully planned, multidimensional strategic
communication strategy that utilizes trained ‘‘buzz agents’’ to convey persuasive messaging to peers
through created events (Ahuja, Michels, Walker, & Weissbuch, 2007), can facilitate purposeful development of positive word of mouth. Characterized by a lack of commercial bias as well as speed and
interactivity, buzz marketing is considered to be more trustworthy and authentic than other sources of
information about products, services, and ideas (East, Hammond, & Lomax, 2008; Silverman, 2001).
Buzz marketing as a social marketing strategy has been applied in social marketing campaigns with
encouraging results, such as the ‘‘Liverpool’s Challenge’’ campaign to fight obesity (Thomas, 2009)
and the HEALTHY intervention to reduce the risk for type 2 diabetes (DeBar et al., 2009). The buzz
marketing strategy thus offers promise for social marketing campaigns.
Theoretical Framework
The focus on buzz agents in this campaign was partly informed by the Diffusion of Innovation theory
(Rogers, 1983). According to this theory, adoption of a product, behavior, or idea follows an S-shaped
curve, where the adoption process is driven by five types of individuals: innovators, early adopters,
early majority, late majority, and laggards. More importantly, this process typically moves through
these five stages sequentially. In other words, for a behavior to be adopted by a majority of the public,
it has to be adopted by a small group of innovators first, after which its followers will include early
adopters.
Buzz marketing strategy is consistent with the diffusion of innovation theory in focusing on
identifying and growing innovators and early adopters first to a critical mass and then letting them,
commonly referred to as buzz agents, spread the idea or behavior to their peers to reach a majority
stage.
Campaign Development
Social Marketing Benchmarks
What differentiates social marketing from other types of marketing activities? Andreasen (2002)
argues that social marketing campaigns take into account six criteria: (1) targeting and segmentation,
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(2) behavior change, (3) competition, (4) exchanges, (5) audience research, and (6) the marketing mix.
The research team actively incorporated these strategies in developing the Whatcha doin? campaign.
Target Audience: Teens
Recent research in social marketing has underscored a consumer-centric perspective, ‘‘inviting consumers to be true partners in determining how to best meet their health needs’’ (Grier & Bryant, 2005,
p. 336).
Through target audience analysis, the research partners agreed that the project would focus on the
state’s teen population. This was identified as a demographic that was ignored in 2006. Adolescents
were clearly not the target audience for existing obesity prevention programs; rather, younger audiences, particularly those under age 12, were observed to have more exposure to age-appropriate
marketing materials concerning healthy food choices and appropriate levels of physical activity.
Efforts to create healthy habits at as young an age as possible had created a gap in programming
during the high school years. And this was at a time when young adults were already known to be
increasingly skeptical of mass media, making it particularly challenging to provoke behavior change
through the use of more traditional communication channels (Beard, 2003).
Behavior Change: Increasing Fruit and Vegetable Consumption and Physical Activity
Data collected at the state level, in particular the 2005 Youth Risk Behavior Survey, found only 36.5%
of high school students reported achieving the recommended 60 min of physical activity on 5 or more
days per week. The study also found only 13.5% of high school students consumed the recommended
daily fruit and vegetable allowance of four and a half to six cups per day. The research team agreed that
a campaign tightly focused on impacting attitudes and behaviors about these three specific activities
would contribute the most to obesity prevention for this project.
Concept Development Research: Initial Primary Data Collection
The research team conducted in-depth interviews about high school students’ attitudes toward fruit and
vegetable consumption and physical activity.
Insights from this qualitative research contributed to the development of the campaign strategy and
to the choice of buzz marketing as the communication channel. The strategy developed for the teen
high school audience was that the decisions to eat fruits and vegetables and to be physically active are
up to each individual and can be realized in many unique ways, not just those defined by adults, and
any of them will contribute to a fun, cool lifestyle as modeled by peers.
The research team then developed three distinct creative approaches for communicating the message. These concepts were presented to the project partners at the state DHHS who provided feedback
that was incorporated into the design concepts.
The refined concepts were then tested on two focus groups from 24 high school students. Participants were asked questions about their own attitudes toward fruit and vegetable consumption and
physical activity and toward the educational materials concerning obesity that were present in their
high schools. They were also asked about the influence of peers on their own behavior. Finally, they
were shown the campaign creative concepts and asked to react both to the creative work and to the
concept of teens marketing the message to other teens.
These data were used to arrive at a visual look and feel for additional testing of the pilot campaign.
In addition, the data revealed a high level of comfort with and confidence in a peer-to-peer communication channel, such as buzz marketing.
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Competition
The insight distilled from the research that came to drive the campaign development was the consistently articulated need for teens to feel they were mature enough to make good individual choices
concerning health and nutrition decisions. Their desire to be unique was balanced by a fear of being too
out of the norm: ‘‘I want to be an individual, just like everybody else.’’
This presented an internal psychological competition of conflicted thoughts among the target
audience, in addition to such external competition as abundant availability of unhealthy food in the
school environment and the perceived social norm that ostracizes healthy eaters. The campaign needed
to walk a fine line between encouraging individual choice and staying within the accepted norms of
each teen group.
Exchanges
The success of a social marketing campaign hinges upon creating compelling exchanges with target
audiences by maximizing the benefits and minimizing the costs (Andreasen, 2002). Through an
exchange analysis, the research team became concerned about the time and effort expected from buzz
agents. In order to overcome such barriers, some incentives or rewards needed to be present (Andreasen, 2002). Providing buzz agents with advance information of the campaign and allowing them to
tailor the tactics to their own environment, thereby boosting their self-efficacy, would arguably
achieve that purpose. This tested well in focus groups, reinforcing Rosen’s (2000) theory that anticipation is an important element in a buzz campaign.
The activities targeted at the general student population were also intended to make sure the benefits
outweighed the costs. For instance, to reduce the cost of spending time looking for a place to do some
physical activity, the research team provided each school with green stability balls to be placed in
classrooms and libraries to keep the students active during class. Buzz agents were encouraged to use
these stability balls to show to their peers how being physically active could be fun.
Campaign Strategy: Peer Buzz Agents
The research partners identified resistance to top-down persuasion commonly found in high school
students compared to those at other grades as a potential threat to health intervention campaigns. On the
other hand, the research team has found peer influence to be a powerful force at this developmental stage.
Use of peer educators or student peer communicators (DeBar et al., 2009) in health campaigns has
been found to be effective in some studies. For instance, one project paired teen mentors with younger
children to promote healthier eating and more physical activity, finding that mentored children had
higher levels of health knowledge, attitudes, and body mass index (Smith, 2011). A peer-led health
promotion program among elementary students, called Healthy Buddies, also reported more healthy
living knowledge among students in intervention schools than in comparison sites (Campbell et al.,
2012). Another tobacco cessation project found schools that used peer supporters achieved a 22%
reduction in smoking among teens compared with control schools (Starkey, Audrey, Holliday, Moore,
& Campbell, 2009).
Testing the Buzz Agents Idea
This formative research provided feedback on the role of the buzz agents in this campaign. Teen focus
group participants viewed the buzz agents concept as a positive element of the campaign, consistent with
other research that shows teens like being buzz agents and that they treat the role as a job (Ahuja et al.,
2007). Students found it important that buzz agents should ‘‘live the lifestyle,’’ stating that peer-to-peer
marketing was only honest if the person selling something truly believed in what they were selling.
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Recruiting Buzz Agents
Fall 2007 became the launch window, a time when teens would be most energized by a new school
year. That time frame then required the development of a process for quickly recruiting and training in
the fall the essential element of the campaign, the buzz agents. The solution was to work through each
high school principal to identify a teacher coordinator who would serve as an on-the-ground recruiter
for and manager of buzz agent teams in each participating school.
With the ability to fit the campaign into their school in a customized way, a variety of teachers
representing different subject matter expertise proposed a diverse range of student groups as buzz
agent teams, including a student council, a nutrition class, a physical education class, and student
clubs. Over the 6 years of the campaign implementation and the involvement of 32 high schools, these
processes worked smoothly and provided the team with a valuable cross section of high school-aged
buzz agents. These students served as the chief communications channel for the campaign concepts.
Campaign Implementation—Social Marketing Mix
The hallmarks of a social marketing campaign are the 4Ps, or the marketing mix: product, price, place,
and promotion (Glassman & Braun, 2010).
Product
A product is what is offered to a market to meet a want or need; it can include core benefits of behavior,
goods or services, or product elements that can help lead to behavior change (Lee & Kotler, 2015).
The product in the Whatcha doin? campaign was a desired behavior change: teens choosing to
consume more fruits and vegetables and to be more physically active. The researchers developed this
product by linking it with the benefit of showing peers they were part of a cool movement. The idea
was packaged with tangible items or ‘‘augmented products’’ (Lee & Kotler, 2015): branded campaign
collateral such as stability balls, T-shirts, stress balls, stickers, and many other items. Buzz agents
demonstrated and exemplified the benefits of adopting this product and encouraged their peers to join
them through peer-to-peer modeling.
Price
Price involves a cost–benefit analysis to consumers. The campaign tried to show that the benefits
outweighed the costs. Students felt they did not have time for physical activity; buzz agents found time
during breaks to engage their peers in physical activities. Students also found fruit and vegetables
undesirable; buzz agents conveyed the benefits to the students and were active consuming fruit and
vegetables themselves.
Place
Place refers to ‘‘where and when the target audience will perform the desired behavior, acquire any
related goods, and receive any associated services’’ (Lee & Kotler, 2015, p. 315). In the case of this
campaign, the high school setting was a bounded system where the target audience was consistently
located. The campaign was built to show the targeted behavior in a location where it was easier for the
buzz agents to perform and model the desired behavior and where the collateral materials could be
more accessible to the target audience. For example, each school received 5–10 green stability balls
that were placed around the building (e.g., classroom, cafeteria, library, and principal’s office) to get
students talking and to keep them active during class.
Struthers and Wang
223
Figure 1. Students exercised with stability balls in the Whatcha? doin campaign.
Promotion
Teacher coordinators received tools and materials for their buzz agent teams to help promote the
campaign within their schools, from detailed packets filled with suggested ways to execute the
campaign to branded collateral such as stability balls, T-shirts, static clings, stickers, and campaign
signs (see Figures 1 and 2 for example). Teams were required to work with their teacher coordinators
each week to first slowly roll out the campaign using stealth tactics and then to stage frequent, branded
‘‘random acts’’ involving fruits, vegetables, and physical activity. In order to keep the campaign new
and alive, each phase of the campaign offered a new goal so that interest never died as the campaign
progressed. Both buzz agents and teacher coordinators participated in periodic conference calls, e-mail
exchanges, and site visits throughout the campaign each year.
Rosen (2000) developed a number of principles to drive a successful buzz marketing campaign. These
included introducing fresh, creative materials associated with the message on a frequent basis; creating
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Figure 2. Students voted to adopt this T-shirt design for the 2012 Whatcha doin? campaign.
plenty of tools to make it easy for the target audience to spread the message; building a sense of
anticipation about the bigger communications story; developing activities that are fun for people to talk
about and share; and even being a little outrageous in order to more effectively engage the audience.
Following these principles, the campaign showed the fun, cool, and even unexpected lifestyle
accessible yet unique to each teen that could come from increased fruit and vegetable consumption
and increased physical activity. The campaign tagline, Whatcha doin’? How you do it is up to you,
encouraged high schoolers to take action in their own way but to certainly take action.
A strong visual brand identity is critical in marketing to adolescents, including things like an eyecatching logo associated with the campaign message (L’Engle, Pardun, & Brown, 2004). A bright lime
green splash evolved as the campaign logo (see Figure 3), and all materials created thereafter used a
well-defined guide to brand standards including color palette, font, and logo.
According to Rosen (2000), the most important aspect of a buzz campaign is to keep the buzz alive.
To do that, the Whatcha doin? campaign was crafted to be ever changing and full of wacky and random
activities that kept the student body constantly guessing. Buzz agents were encouraged to use their own
imaginations and to stage many small low-cost but unexpected activities. Dubbed by the research
teams as ‘‘random acts,’’ these events were meant to catch people off guard and also empowered the
buzz agents to work with their teacher coordinator and school administration on surprise ‘‘secret’’
activities. By utilizing the Whatcha doin? signs, stickers, and T-shirts to properly brand the random
acts, students in the schools linked the randomness with the campaign, which effectively kept both the
buzz and the campaign alive (see Figure 4 for a random act that engaged students). Hence, the
placement in the marketing mix was not static in this campaign; rather, it was quite dynamic in that
buzz agents could decide when and where to stage the acts.
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Figure 3. Whatcha doin? Campaign Logo.
Campaign Time Line
The research team conducted a pilot study in four schools at one school district involving 32 buzz
agents in 2007 before executing the full scope of the campaign. Upon receiving positive feedback from
school partners and participants through quantitative and qualitative survey instruments, the research
team kept running the campaign for 5 more years on a bigger scale involving more buzz agents in more
schools throughout our Midwestern state. With all their responsibilities and materials, the buzz agents
had the most intense engagement in the campaign of any students.
Research Hypotheses
Knowing that the success of a buzz campaign rested in these ‘‘buzzers’’’ hands, the research
team began to ask whether the buzz agents would enjoy their participation in campaign
activities so much that it would actually impact their own attitudes and behavior around the
campaign’s goals: increased fruit and vegetable consumption and physical activity. Such
evaluations are in line with the need for a ‘‘return on investment’’ (ROI) analysis for social
marketing campaigns.
Buzz agents played a critical role in this social marketing campaign; accordingly, the research
team invested most of its resources on this core group of students. It will be hard to believe the
campaign had an impact on the majority of the high school students if attitude toward the campaign
did not even lead to improved health attitudes and behaviors among these buzz agents. Hence, we
expected that engagement with the campaign would foster liking for the campaign among these buzz
agents, which in turn would lead to an improvement in health attitudes and an increase in health
behaviors. Utilizing data from their responses to year-end surveys, the research team tested the
following centered on buzz agents:
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Social Marketing Quarterly 22(3)
Figure 4. Students got involved in the Whatcha doin? campaign with buzz agents.
Hypothesis 1: Attitude toward the Whatcha doin? buzz campaign is positively associated with
an improvement in health attitudes toward (a) being physically active, (b) eating fruit, and (c)
eating vegetables.
Hypothesis 2: Attitude toward the Whatcha doin? buzz campaign is positively associated with
an increase in health behaviors, such as (a) the amount of physical activity, (b) fruit intake, and
(c) vegetable intake.
Method
Sample
Survey respondents, who were the buzz agents from participating schools, were unique due to the new
configuration of participating schools and students each year of the campaign. The volunteer teacher
coordinators were tasked with assembling a team within their own school, resulting in different
students assuming buzz agent duties each year.
All of the teacher coordinators from the 32 participating schools over the 6-year campaign were
asked to administer the survey to their school buzz agents near the end of the campaign each academic
year. As the liaison between the researchers and the buzz agents, the teacher coordinators could choose
to administer the survey or not.
The campaign coordinator was charged with inviting the teacher coordinators to participate, distributing the appropriate number of the paper survey instruments to them all and following up with
requests to administer and return the surveys in postage-paid envelopes provided with the surveys. A
financial incentive was used to encourage participation by the teachers: A US$100 gift card was
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Table 1. The Number of Schools that Participated in the Whatcha doin? Campaign Each Year and the Number of
Buzz Agents Who Completed the Surveys.
Campaign Year
Schoolsa
2007–2008
2008–2009
2009–2010
2010–2011
2011–2012
2012–2013
4
12
15
13
12
20
(4)
(11)
(6)b
(9)b
(10)
(10)
Buzz Agents (Response Rate)
32
97
74
78
73
71
(100%)
(58.79%)
(67.89%)
(53.06%)
(42.44%)
(34.98%)
a
Number in parenthesis indicates the number of schools where buzz agents returned survey questionnaires.
Pretest and posttest surveys were administered in these 2 years. Number in parenthesis indicates the number of schools where
buzz agents returned posttest survey questionnaires that were analyzed in this study.
b
offered to those who returned surveys to the campaign coordinator. The number of teacher coordinators who chose to participate impacted response rates significantly from year to year, as did the
effectiveness of the campaign coordinator, a unique individual in each of the 6 years of the campaign.
The mix of participating schools each year was different, including a wide variety of rural and urban
schools across the state. These schools ranged in student population from 136 to more than 1,700. The
Nebraska Department of Education (2012) recorded an increase across the state in the number of
students on free or reduced lunch during the 6-year campaign, from 37.33% the year the campaign
launched (2007–2008) to 43.79% the last year reported (2011–2012).
Data
The Whatcha doin? buzz campaign was implemented each academic year in participating high schools
in Nebraska from 2007 to 2013. A survey instrument was distributed to buzz agents each year to assess
the effectiveness of campaign tactics used in each school, buzz agents’ evaluations of the campaign,
and their own health attitudes and behaviors. Formative evaluation provoked evolution of the questionnaire each year, but a core set of questions was included in each survey in order to track longitudinal changes in key indicators.
To evaluate the effectiveness of the whole Whatcha doin? campaign, the research team combined
cross-sectional data collected from the buzz agents over the 6-year period into one data set (n ¼ 425) to
test the hypotheses.
Longer survey instruments were distributed to buzz agents in W2009–2010 and W2010–2011 that
included additional measures of health behavior. The responses to the new questions from these 2
years were combined together into another data set to provide an alternative test of Hypothesis 2.
The number of participating schools, the number of buzz agents who completed the surveys in each
cross-sectional wave, and the response rate each year are reported in Table 1.
Measures: Independent Variables
The independent variables included measures of demographics, campaign year, and campaign attitude.
Descriptive statistics are reported in Table 2.
Demographic variables. Three demographic variables were controlled for grade, sex, and race.
For the whole sample from 2007 to 2012, buzz agents ranged from Grade 9 to Grade 12, with the
majority from Grade 10 (Grade 9: 19.3%; Grade 10: 35.5%; Grade 11: 26.4%; Grade 12: 18.8%). This
variable can also be viewed as a proxy for age. Most of the buzz agents were females (71.43%) and
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Social Marketing Quarterly 22(3)
Table 2. Descriptive Statistics.
Variables
n
Whole sample (W2007–2008–W2012–2013)
Grade
420
Male
420
White
420
Year
425
Campaign attitude
420
Physical attitude
414
Fruit attitude
411
Vegetable attitude
413
Physical behavior
411
Fruit behavior
410
Vegetable behavior
404
Subsample (W2009–2010 and W2010–2011)
Grade
148
Male
149
White
149
Year
152
Campaign attitude
152
Daily physical activity
152
Daily cups of fruit
149
Daily cups of veggies
148
Min.
Max.
Mean
SD
9
0
0
1
1
0
0
0
0
0
0
12
1
1
6
5
1
1
1
1
1
1
10.45
0.29
0.72
3.65
4.05
0.66
0.63
0.51
0.50
0.64
0.44
1.006
0.45
0.45
1.58
0.67
0.47
0.48
0.50
0.50
0.48
0.50
9
0
0
1
1
0
0
0
12
1
1
2
5
7
12
6
10.49
0.26
0.62
1.51
3.86
2.64
1.73
1.50
1.00
0.44
0.49
0.50
0.72
1.74
1.28
1.07
Whites (71.9%). Similar demographic profiles hold for the subsample of buzz agents from 2009 and
2010. The majority came from 10th grade (33.8%) and were females (73.8%) and Whites (62.4%).
Campaign year. Since the 6 years of cross-sectional data were combined together, a campaign year
variable was included ranging from 1 (denoting W2007–2008) to 6 (denoting W2012–2013) to control for
the possibility that the campaign had stronger effects in later years as the campaign matured. A
dichotomous campaign year variable was used for the subsample from W2009–2010 and W2010–2011.
Campaign attitude. This is the key explanatory variable in this study. Each year, buzz agents were asked
‘‘how would you describe your experience as a buzz agent?’’ Responses were measured on a 5-point
scale from loved it, liked it, no opinion, didn’t like it, to hated it. This variable was reverse coded so that
a higher value indicated more positive experiences. Buzz agents were also asked ‘‘overall, what is your
attitude toward the Whatcha doin? campaign?’’ The same response categories were offered, and the
same recoding procedure was followed. These two questions were strongly correlated (r ¼ .62,
p < .001), and therefore, they were averaged to create a campaign attitude index (W2007–2008 to
W2012–2013: M ¼ 4.05, SD ¼ 0.67; W2009–2010 to W2010–2011: M ¼ 3.86, SD ¼ 0.72).
Measures: Dependent Variables
The focus of this project is on the health attitudes and health behaviors as outcomes of this buzz
campaign. Each year, buzz agents were asked whether they personally changed the following during
the course of the Whatcha doin? campaign: (1) attitude toward being active, (2) attitude toward eating
fruit, (3) attitude toward eating veggies, (4) amount of physical activity, (5) fruit intake, and (6)
vegetable intake. Response categories included ‘‘increased,’’ ‘‘decreased,’’ and ‘‘stayed the same.’’
Respondents who indicated an increase to each of these questions were coded as 1, while the other two
categories were coded as 0 because the researchers were interested in whether the intervention
increased physical activity or fruit/vegetable intake or not.
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Admittedly, some information was lost by collapsing two categories together. Nevertheless, the
researchers believe it is justified for at least two reasons. First, theoretically, the team is more interested in whether the campaign resulted in an improvement in any of the health indicators; as a result,
binary coding sufficed. Furthermore, very few buzz agents, and at times none, indicated a decrease in
these indicators. Hence, dichotomous coding is warranted.
Overall, 66.2% of buzz agents improved their attitude toward being active, 62.8% improved their
attitude toward eating fruit, and 51.3% improved their attitude toward eating veggies. In terms of
health behaviors, 49.9% increased the amount of physical activity, 63.9% increased their fruit intake,
and 43.8% increased their veggie intake. Evidently, positive attitudinal and behavioral changes regarding vegetables lagged behind physical activity and fruit intake.
In addition, several new items to measure health behaviors were included in W2009–2010 and
W2010–2011. For physical activity, buzz agents were asked whether they did any of the following
on a daily basis: (1) sports practice, (2) marching band, (3) personal running, (4) biking, (5) Rollerblading, (6) skateboarding, (7) workout videos, (8) housework/chores, (9) fitness center, (10) farm
work, and (11) Physical Education (PE)/gym class. For each of these activities, responses were
coded 1 if the buzz agent did it and 0 if the agent did not. These 11 items were summed to create a
daily physical activity index (M ¼ 2.64, SD ¼ 1.74).
Buzz agents from W2009–2010 and W2010–2011 were also asked how many cups of fruits (M ¼ 1.73,
SD ¼ 1.28) and vegetables they ate on an average day (M ¼ 1.50, SD ¼ 1.07). To make sure that
respondents had the same anchor point, prompts were provided suggesting that one cup of fruit is
equal to a baseball, a medium apple, or a large orange, and a half cup of fruit is similar to 4 large
strawberries or 16 grapes. For vegetables, the prompts were that one cup is equal to a baseball,
12 baby carrots, or a medium potato, and a half cup is similar to one cup of lettuce or 5 broccoli
florets. These questions from W2009–2010 and W2010–2011 provided the research team with additional
measures of the dependent variables to test Hypothesis 2, enabling the researchers to validate the
findings that relied on a different set of outcome measures.
Results
To test the hypotheses, a series of logistic regression models were run on the outcome variables
controlling for grade, sex, race, and campaign year for the 6-year whole sample. Furthermore, several
ordinary least squares regression models were run on the pooled data from W2009–2010 and W2010–2011 to
provide additional tests of campaign effects on health behavior.
Health Attitudes
Table 3 shows results from three logistic regressions on the health attitude variables from the whole
sample. Hypothesis 1 predicts that attitude toward the Whatcha doin? buzz campaign is positively
associated with an improvement in health attitudes. As can be seen in Model I results, campaign
attitude is indeed positively associated with improved attitude toward being physically active (B ¼ .92,
SE ¼ .19, p < .001). An odds ratio of 2.50 suggests that buzz agents were 2.5 times as likely to improve
their attitude toward being physically active when their campaign attitude increased one unit. Hence,
Hypothesis 1a is supported.
Results from Model II show that campaign attitude is also positively associated with improved
attitude toward eating fruit (B ¼ .96, SE ¼ .19, p < .001). An odds ratio of 2.60 suggests that buzz
agents were 2.6 times as likely to improve their attitude toward eating fruit when their campaign
attitude increased one unit, confirming Hypothesis 1b.
In a similar vein, campaign attitude is positively associated with improved attitude toward eating
vegetables (B ¼ .60, SE ¼ .17, p < .001), as Model III in Table 3 demonstrates. An odds ratio of 1.83
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Table 3. Effects of Attitude Toward Whatcha doin? Campaign on Health Attitudes From 2007 to 2012.
Model I: Improved
Attitude Toward Being
Physically Active
Independent Variables
Grade
Male
White
Year
Campaign attitude
Constant
Cox and Snell R2
Nagelkerke R2
n
B (SE)
eB
0.072 (0.113)
0.074 (0.250)
0.208 (0.251)
0.104 (0.071)
0.917*** (0.187)
2.806* (1.405)
.088
.122
404
0.931
1.077
1.231
1.110
2.502
0.060
Model III: Improved
Attitude Toward
Eating Vegetables
Model II: Improved
Attitude Toward
Eating Fruit
eB
B (SE)
0.036
0.074
0.578*
0.103
0.958***
2.887*
(0.109)
(0.241)
(0.262)
(0.069)
(0.188)
(1.370)
.086
.118
401
0.964
0.928
0.561
1.108
2.606
0.056
B (SE)
0.134
0.042
0.052
0.084
0.601***
4.067**
(0.104)
(0.229)
(0.240)
(0.065)
(0.170)
(1.305)
.045
.060
403
eB
1.144
1.043
0.949
1.087
1.825
0.017
Note. Entries are coefficients from logistic regressions on the pooled sample of all buzz agents in the study. For Model I,
respondents who indicated that they ‘‘improved’’ their attitudes toward being active were coded as 1; those who chose ‘‘got
worse’’ or ‘‘stayed the same’’ were coded as 0. For Models II and III, the same coding protocol was followed for attitudes toward
eating fruit and vegetables.
*p < .05. **p < .01. ***p < .001.
Table 4. Effects of Attitude Toward Whatcha doin? Campaign on Health Behavior From 2007 to 2012.
Model I: Increased Amount
of Physical Activity
Independent Variables
Grade
Male
White
Year
Campaign attitude
Constant
Cox and Snell R2
Nagelkerke R2
n
B (SE)
eB
0.055 (0.109)
0.299 (0.242)
0.083 (0.251)
0.233*** (0.068)
1.049*** (0.194)
4.704*** (1.382)
.128
.170
401
0.946
1.348
1.087
1.262
2.855
0.009
Model II: Increased
Fruit Intake
B (SE)
0.140
0.012
0.387
0.168*
0.766***
4.292**
(0.110)
(0.243)
(0.257)
(0.070)
(0.180)
(1.285)
.074
.101
400
Model III: Increased
Vegetable Intake
eB
B (SE)
eB
1.150
0.988
0.679
1.183
2.152
0.014
0.056 (0.105)
0.433 (0.231)
0.176 (0.243)
0.101 (0.066)
0.496** (0.171)
3.222* (1.307)
.037
.050
396
1.058
1.541
0.839
1.106
1.641
0.040
Note. Entries are coefficients from logistic regressions on the pooled sample of all buzz agents in the study. For Model I,
respondents who indicated that they ‘‘increases’’ the amount of physical activity were coded as 1, and those who chose
‘‘decreased’’ or ‘‘stayed the same’’ were coded as 0. For Models II and III, the same coding protocol was followed for fruit and
vegetable intake.
*p < .05. **p < .01. ***p < .001.
suggests that buzz agents were about twice as likely to improve their attitude toward eating vegetables
when their campaign attitude increased one unit. Again, Hypothesis 1c is supported.
Health Behaviors
Table 4 reports results from three logistic regressions on the health behavior variables.
Hypothesis 2 predicts that attitude toward the Whatcha doin? buzz campaign is positively associated with an increase in health behaviors. Model I shows that campaign attitude is indeed positively
associated with increased amount of physical activity (B ¼ 1.05, SE ¼ .19, p < .001). An odds ratio of
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Table 5. Effects of Attitude Toward Whatcha doin? Campaign on Health Behavior in 2009 and 2010.
Model I: Amount of Daily Physical Activities
Independent Variables
Grade
Male
White
Year
Campaign attitude
Constant
Adjusted R2
n
B (SE)
0.080
0.210
0.660*
0.530
0.619**
1.588
.108
145
(0.148)
(0.320)
(0.299)
(0.295)
(0.202)
(1.669)
b
.045
.053
.181
.151
.252
Model II: Cups of Fruit Eaten Per Day
B (SE)
0.005
0.114
0.391
0.275
0.479**
0.097
.071
143
(0.111)
(0.241)
(0.226)
(0.222)
(0.152)
(1.249)
b
.004
.039
.146
.107
.266
Note. Entries are coefficients from ordinary least squares regressions on the pooled sample of buzz agents from W2009–2010 and
W2010–2011. Model I tests campaign effects on the amount of daily physical activity and Model II on the amount of fruit, measured
in cups, eaten on an average day.
*p < .05. **p < .01. ***p < .001.
2.86 means that buzz agents were almost 3 times as likely to increase their physical activity when their
campaign attitude increased one unit, lending support to Hypothesis 2a.
Consistent with Hypothesis 2b, campaign attitude is shown in Model II to be positively associated with increased fruit intake (B ¼ .77, SE ¼ .18, p < .001). An odds ratio of 2.15 denotes that
buzz agents were about twice as likely to eat more fruits when their campaign attitude increased
one unit.
As Hypothesis 2c predicts, campaign attitude is also positively associated with increased vegetable intake (B ¼ .50, SE ¼ .17, p < .01), as shown in Model III. An odds ratio of 1.64 suggests that
buzz agents were 1.64 times as likely to eat more vegetables when their campaign attitude increased
one unit.
Next, we turn to additional health behavior indicators included in W2009–2010 and W2010–2011 to see if
the same pattern holds with alternative measures of health behavior change. The results are reported in
Table 5.
After controlling for grade, sex, race, and year, we still find statistically significant positive
association between campaign attitude and the amount of daily physical activity (B ¼ .62, SE ¼
.20, p < .01), lending further support to Hypothesis 2a. The model explains 10.8% of the variance in
daily physical activity, and campaign attitude is the strongest predictor (b ¼ .25).
Just as Hypothesis 2b predicts, campaign attitude is also positively associated with the amount of
fruits eaten every day (B ¼ .48, SE ¼ .15, p < .01). This model explains 7.1% of the variance in the
amount of fruits eaten and campaign attitude is again the strongest predictor (b ¼ .27).
Lastly, we tested the effect of campaign attitude on the amount of vegetables eaten every day.
Unfortunately, we did not find a statistically significant relationship between these two variables
(B ¼ .14, SE ¼ .13, ns). Hence, Hypothesis 2c is not supported by the data from this subsample.
Discussion
Lesser Impact on Vegetable Consumption
The purpose of this study was to describe the evolution of a social marketing campaign using buzz
marketing tactics, including buzz agents, and to discern whether attitude toward such a social
marketing campaign by the participating buzz agents would be positively associated with an
improvement in health attitudes and behaviors regarding being physically active, eating fruit, and
eating vegetables.
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Social Marketing Quarterly 22(3)
The results of the analysis of survey data from 6 years’ worth of buzz agents support the thesis that a
positive attitude toward the campaign itself resulted in improved attitudes toward all three components
of the campaign messaging. Attitudes toward increased fruit consumption and increased physical
activity showed the most impact, vegetable consumption to a lesser extent.
Perhaps more importantly, attitude toward the campaign itself had positive impacts on self-reported
healthy behaviors. Again, fruit intake and physical activity levels experienced the most significant
increases. However, results on vegetable consumption are mixed: Attitude toward the campaign was
indeed associated with increased vegetable consumption in the overall sample, but this relationship
disappeared when the researchers used a different measure of vegetable consumption among a subsample. This can speak to the challenge of the changing vegetable consumption behavior among
teenagers. While findings regarding fruit intake and physical activity are quite robust, the unreliability
of the impact on vegetable consumption suggests that scholars and public health professionals should
devote more research to this area.
Lessons From Engaging Buzz Agents
Buzz agent engagement may provide a model for reaching the adolescent population with behaviorchanging obesity prevention messages. How did the research team cultivate buzz agents’ positive
relationships with the Whatcha doin? campaign itself? First, the team made the campaign fun and
engaging for these buzz agents. They were the first to see and experience all the elements of the
campaign. In the campaign, buzz agents were made keepers of the secret, acting as those in their
schools who could stealthily roll out the activities that launched the campaign. They were very handson, illustrating the messages to their peers on a frequent, regular basis through their staged random
acts. They received fun, low-cost, branded collateral materials, such as T-shirts, stress balls, stability
balls, stickers, and window clings, which they shared with their peers but also got to keep.
Furthermore, buzz agents were encouraged to own the campaign themselves. Empowered to
customize the campaign to their own school environment, working with their teacher coordinator
and their school administration to choose from a wide array of potential activities and events created
by the research team, buzz agents were responsible for the success or failure of the campaign in the
long term and for weekly meetings and activities in the short term. The campaign depended on them.
They were the owners of the campaign, not some higher authority dictating how they or their peers
should lead their lives; as a result, they had an intense, immersive relationship with the campaign and
its core messages.
Buzz agents reported the kind of improvements in key obesity-prevention attitudes and behaviors
that public health officials want to achieve. The Whatcha doin? campaign, by following the best
practices for both social marketing and buzz marketing as recommended by scholars in past literature,
produced an academic-year experience for the buzz agents that had significant impact on their health
and nutrition attitudes and behaviors.
Scaling Up the Campaign
The issue of how to scale a buzz marketing public health campaign presents a number of concerns. The
number of buzz agents relative to the total population of each school was relatively small, comprising
at best an estimated 5% maximum of the whole student body. While this study reports only the data
collected from this small subset of students in each school who were buzz agents, surveys were
distributed to the entire student body in the first 2 of the 6 years of the campaign. Results from that
study showed that student exposure to buzz marketing affected their attitudes toward the campaign,
which in turn improved health attitudes (Wang & Struthers, 2014).
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There were a number of challenges to surveying the entire student body of up to 15 high schools
each year. High school students are, for the most part, minors, and so parental consent to participate in
the research is required. Also, the researchers relied on teachers to administer the surveys and return
them; these educators were required to use class time to administer and collect the survey. This
resulted in lower response rates than desired. For these reasons, the yearly survey of the entire student
body of each school was abandoned after the first 2 years, making it more difficult to report on any
broader impact.
To give more adolescents the same deep experience with a campaign they own and enjoy as the
buzz agents have, the Whatcha doin? campaign could be incorporated into more classes as part of the
curriculum. However, curriculum changes are difficult to achieve, and schools continue to work under
the pressures of preparing students to succeed on state and national standardized tests, making the
addition of new material difficult.
The willingness of teachers to step up as coordinators may be another limitation to broader use of the
buzz agent concept. This may be just one more additional project added to an already busy work life.
Finally, the resource issue at the state level is also a concern. The campaign itself was relatively low
cost: For example, the 2012–2013 year’s campaign was just under US$20,000 for the undergraduate
intern and all the campaign collateral material. Yet there is a cost, and sometimes even US$20,000 is
difficult for a state to put to such a campaign.
It should be noted that this project illustrates a model for a low-cost alternative to the creation and
execution of a public health campaign, which is a series of choices prompted by the very lack of
funding. The first choice was for the DHHS to collaborate with students and researchers at an
institution of higher education rather than working with an ad agency. The costs could increase
dramatically if a professional advertising agency were to create the campaign identity and design and
produce the collateral materials. The choice of collateral pieces could also impact the total campaign
cost; this project made low-cost choices such as branded stability balls, T-shirts, and simple digital
cameras to provide to participating schools. It is also important to consider that a campaign using buzz
marketing eschews traditional mass media, so the total cost will by definition be significantly less than
producing television or radio spots, and then purchasing television or radio time, or producing glossy
print ads and then purchasing print advertising placement in teen magazines.
The ROI for the Nebraska DHHS was the number of high school students in Nebraska reached
through the campaign, who improved their health attitudes and behavior. This campaign made sure
buzz agents were committed first, who then influenced their peers. The evaluations reported in this
article have shown campaign attitudes made a difference.
Conclusion
Despite these concerns, this project has shown that a positive attitude toward a social marketing
campaign employing a peer-driven buzz marketing strategy can indeed improve health attitudes and
behaviors among teens. While the small number of buzz agents may be perceived as producing too
little impact, the data suggest that this concept is worth further testing. Given the scale of the nation’s
obesity epidemic, future research on the use of buzz marketing in a social marketing public health
context is warranted.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication
of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
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Social Marketing Quarterly 22(3)
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Author Biographies
Amy Struthers (MA, University of Nebraska-Lincoln) is associate professor in the College of Journalism and Mass Communications at the University of Nebraska-Lincoln. Her research agenda is focused
on health and science communication, with a particular focus on public health messaging to
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adolescents. Her research has been funded by the CDC, USDA and USAID and presented at the CDC
National Conference on Health Communications, Marketing and Media.
Ming Wang (Ph.D., University of Wisconsin-Madison) is assistant professor in the College of Journalism and Mass Communications at the University of Nebraska-Lincoln. His research interests focus on
the impact of new communication technologies, particularly social and mobile media, on advertising,
public relations and political communication. His research has been published in leading communication journals, such as Journal of Communication and Communication Research.