A First Step Toward Healthy Eating: The 1% Or Less Handbook

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A First Step TowardHealthy Eating:The 1% Or LessHandbookMargo G. Wootan, D.Sc.Center for Science in thePublic Interest1875 Connecticut Avenue, N.W., Suite 300Washington, DC 20009-5728(202) 332-9110, ext. 352fax: (202) 265-4954mwootan@cspinet.org

AcknowledgmentsMany individuals contributed to the development of the 1% Or Less campaign and the 1% OrLess Handbook. I am especially grateful to Leslie Quillin for her assistance with preparingcampaign materials and the Handbook. I also thank Wendie Rosofsky, Karen McMillan, HolliSmith, Georgia Hatfield, Dr . Lora Wilder, Allison Birney, and the Beach Cities HealthDistrict for their help in developing campaign programs and sections of the Handbook. I alsothank Dr. Bill Reger, West Vir ginia University, the West Virginia Bureau of Public Health,and the citizens of Clarksburg and Bridgepor t, West Vir ginia, for their support of the pilot 1%Or Less campaign.The comments and suggestions of Dr. Howell Wechsler, Dr. Laura Sims, Terry Long, andLinda Weinberg also contributed to this work and are deeply appreciated.All rights reser ved. This book may not be reproduced in any form without wr itten permissionof the publisher, except for the use of materials identified within as being necessary for theconduct of a local or state-wide health-education campaign.Copyright 1996 by Center for Science in the Public InterestFirst Printing: September 1996

ContentsPart 1: Getting StartedAuthors’ Note . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .viiWhat the Experts Say about the 1% Or Less Campaign . . . . . . . . . ixQuotes from Community Members about 1% Or Less . . . . . . . . . . xiChapter 1: The Basics of 1% Or Less1The National Campaign . . . . . . . . . . . . . . . .The First Local 1% Or Less Campaign . . . . . .Your Campaign . . . . . . . . . . . . . . . . . . . . .Why Devote a Whole Campaign to “Just Milk”?Making a Case for Good Nutrition . . . . . . . . .Who Is CSPI? . . . . . . . . . . . . . . . . . . . . . .113479Chapter 2: Getting Started11How to Use the 1% Or Less Handbook . . . . . . . . . . . . . . . .Designing a Campaign to Meet the Needs of Your Community .Institutional Changes and Advocacy . . . . . . . . . . . . . . . . . .Choosing the Right Mix of Progr ams for Your Campaign . . . .Funding Your Campaign . . . . . . . . . . . . . . . . . . . . . . . . .Initial Organizing Steps . . . . . . . . . . . . . . . . . . . . . . . . . .Diffusing Opposition . . . . . . . . . . . . . . . . . . . . . . . . . . . .Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .General Campaign Materials . . . . . . . . . . . . . . . . . . . . . . .Stay “On Message” . . . . . . . . . . . . . . . . . . . . . . . . . . . .11121415182426272932Chapter 3: Community Organizing33Form a 1% Or Less Commission . . . . . . . . . . .Roles of the Commission . . . . . . . . . . . .Tips for Choosing Members . . . . . . . . . .Letters of Endor sement . . . . . . . . . . . . .Organize a Nutrition Action Council . . . . . . . .Roles of Volunteers . . . . . . . . . . . . . . . .Responsibilities of Volunteers . . . . . . . . .Tips for Recruiting Volunteers . . . . . . . . .Working with the Nutrition Action CouncilEvaluation and Appreciation . . . . . . . . . .Develop a 1% Or Less Speakers Bureau . . . . . .Sites for Speakers Bureau Presentations . . .iii.3333343636363739. . . . . . 40424344

Running a Speakers Bureau . . . . . . . . . . .Media Coverage of Campaign PresentationsTime Line: 1% Or Less Commission . . . . . . . . .Time Line: Nutrition Action Council . . . . . . . . .Time Line: 1% Or Less Speakers Bureau . . . . . .4447485052Chapter 4: Advertising54Why Advertise? . . . . . . . . . . . . . . .1% Or Less Advertisements . . . . . . .Cost and Placement of AdvertisementsA Final Note about Advertising . . . . .54555760Chapter 5: Media Relations62The Importance of Media Coverage to Your Campaign . . .Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Choose Campaign Spokespersons and a Media CoordinatorDevelop a Press List . . . . . . . . . . . . . . . . . . . . . . . . .Meet the Press . . . . . . . . . . . . . . . . . . . . . . . . . . . . .General Tips for Working with the Media . . . . . . . . . . .News Releases . . . . . . . . . . . . . . . . . . . . . . . . . . . . .News Conferences . . . . . . . . . . . . . . . . . . . . . . . . . .Interviewing Tips . . . . . . . . . . . . . . . . . . . . . . . . . . .Ideas for Media Events during the Campaign . . . . . . . . .Campaign Kick Off . . . . . . . . . . . . . . . . . . . . .Taste-Test Kick Off . . . . . . . . . . . . . . . . . . . . .The Physician Press Conference . . . . . . . . . . . . .Midpoint News Release . . . . . . . . . . . . . . . . . .Closing Ceremonies for the Campaign . . . . . . . . .Other Ideas for Generating Press Coverage . . . . . .Track Media Coverage of the Campaign . . . . . . . . . . . .Thank the Press . . . . . . . . . . . . . . . . . . . . . . . . . . . .626364656668697072747478808282838787Chapter 6: Supermarket Programs88Why Conduct Campaign Activities in Supermarkets?Recruiting Supermarkets to Join the Campaign . . . .Program Suggestions . . . . . . . . . . . . . . . . . . . . .Promotions of 1% or Skim Milk . . . . . . . .Shelf Talkers . . . . . . . . . . . . . . . . . . . . .Taste Tests . . . . . . . . . . . . . . . . . . . . . .Joint Advertising with Supermarkets . . . . . .iv.88888989909094

Monitor Pr ogress of Campaign and Supermarket Activities . . . . . . . 94Time Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Chapter 7: School Programs99Why Conduct 1% Or Less Activities in Schools? . . . . . . . . . . . .Gaining School Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Suggested Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Institutional Changes in the Milk Served to School Children .Marketing Low-Fat Milk to School Children . . . . . . . . . . .Taste Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Presentations on the Importance of Nutr ition andDrinking Lower-Fat Milk . . . . . . . . . . . . . . . . . . . . . .Integrating the Campaign Message into Classroom CurriculaPoster Contest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Milk-Cap-Collecting Contest . . . . . . . . . . . . . . . . . . . . .Pledge for Health Contest . . . . . . . . . . . . . . . . . . . . . . .Teen Nutrition Team (TNT) . . . . . . . . . . . . . . . . . . . . .Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Time Line for Conducting Poster Contest . . . . . . . . . . . . . . . . . 99100101102103104105105105109111112113115Chapter 8: Worksite & Community Organization ProgramsWhy Conduct Campaign Activities in Worksitesand Community Organizations? . . . . . . . . . . . .Recruiting Worksites and Community OrganizationsProgram Options . . . . . . . . . . . . . . . . . . . . . . .1% Or Less in Food Service . . . . . . . . . . .Newsletter Articles . . . . . . . . . . . . . . . . .Displays of the Amount of Fat in Milk . . . .Presentations on Nutrition and Health . . . . .Taste Tests . . . . . . . . . . . . . . . . . . . . . .Pledge for Health Contests . . . . . . . . . . . .Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . .Time Line . . . . . . . . . . . . . . . . . . . . . . . . . . .118.118119121121121122122122123124125Chapter 9: Church and Synagogue ProgramsWhy Conduct 1% Or Less Activities inGain Support of Religious Leaders . . .Recruit Volunteers . . . . . . . . . . . . .Suggested Activities . . . . . . . . . . . .Bulletin Inserts . . . . . . . . . . .Religious Institutions?.v127.127127128129129

Health-Related Sermons or AnnouncementsSpeakers and Taste Tests . . . . . . . . . . . .Posters and Bulletin Board Displays . . . . .Testimonials . . . . . . . . . . . . . . . . . . . .Timing . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . .Time Line . . . . . . . . . . . . . . . . . . . . . . . . . .129130130131131131132Chapter 10: Additional ResourcesCalcium and Osteoporosis . . . . . . .Children and Nutr ition . . . . . . . . .Community Health Progr ams . . . . .Fundraising . . . . . . . . . . . . . . . . .General Nutrition . . . . . . . . . . . .Heart Disease and Cancer PreventionMedia Relations . . . . . . . . . . . . . .Milk . . . . . . . . . . . . . . . . . . . . .Organizations with Related Resources135.vi.135135136136137138138139139

1%OrLessSeptember 1996Dear Colleague:Thank you for your interest in 1% Or Less. CSPI has been doing nutrition education for thepast 25 years. During that time, we have seen a number of important changes in the foodenvironment, such as the Nutrition Facts label on packaged foods, the increasing availability oflow-fat foods in supermarkets, and the appearance of healthy choices at fast-food restaurants.Interest in nutrition has incr eased dramatically. In a recent national survey, 80% ofAmericans said good nutrition was important to them. Yet, diet-related diseases still cause toomuch sickness, disability, and death in this country. Every year poor diet, along with physicalinactivity, kills 400,000 Americans -- as many as die from smoking. Those deaths show up asheart disease, cancer, stroke, and diabetes, four of the seven leading causes of death in theUnited States.1% Or Less is a new approach to reduce the burden of diet-related disease in this country.Rather than encouraging people to overhaul their entire diet or lifestyle all at once, it has onetargeted, simple, and important message. It encourages adults and children over the ageof two years to switch from whole or 2% milk to 1% or skim milk.The campaign focuses on milk because of its important contribution to both health and disease.Milk is an important source of calcium and vitamin D for strong bones. However, whole and2% milk also are among the biggest contributors of saturated fat to Americans' diets.Switching to low-fat milk is one of the easiest ways for Americans to get the calcium theyneed, while reducing their saturated fat intake and heart disease risk.The 1% Or Less Handbook describes how to plan, implement, and evaluate a communitywide, nutr ition-education campaign. It can be used by a novice in community organizing orby an expert. The Handbook includes a wide choice of program options to allow you to plan acampaign that meets the needs of your community, as well as your budget. Each of theprograms described includes a tested set of materials such as model letters, handouts,evaluation forms, and other materials to allow you to focus your time and energies on thechallenges of implementation and tailoring programs to your target audience.A Project of the Center for Science in the Public Interest1875 Connecticut Avenue, NW, Suite 300 9 Washington, DC 20009 9 (202) 332-9110 9 FAX (202) 265-4954

We encourage you to conduct a community-wide 1% Or Less campaign. However, if timeand resources are limited, consider starting with programming in one setting, such assupermarkets, worksites, or schools. Although CSPI cannot offer any financial resources toconduct local campaigns, this Handbook includes information on securing funds. Yourcampaign can be conducted in partnership with CSPI or you can use the ideas and materials inthe Handbook to run an independent campaign.We hope you find, as we have, that conducting a 1% Or Less campaign not only promotes thepublic' s health but also is a lot of fun. It is inspiring to see people work together to promotethe health of their family and friends, and gratifying to see your efforts result in measurableimprovements in eating habits. Please keep us apprised of the progress of your project andcall if we can be of assistance.Best wishes,Margo G. Wootan, D.Sc.Senior Staff ScientistMichael F. Jacobson, Ph.D.Executive Director

What the experts say aboutthe 1% Or Less campaign“The campaign seems to have been a simple, successful, and relatively inexpensiveundertaking to reduce one of the major sour ces of saturated fat. Milk is a healthy drinkprovided that the fat is removed. This approach has the potential to save many lives.”Basil Rifkind, M.D.Senior Scientific Advisor of Vascular Residency ProgramsNational Heart, Lung, and Blood InstituteNational Institutes of Health“Rar ely do we see market shares change so rapidly. Clearly, CSPI is onto something thatshould be expanded. An impressive achievement with important implications.”Alan BergSenior Nutrition Advisor, World Bank“This community-wide education campaign has achieved a dramatic shift in eating habits. Itnow needs to be expanded to reach the rest of the country. ”Dean Ornish, M. D.President and Director, Preventive Medicine Research Institute“CSPI’s campaign shows that the promotion of low-fat milk causes people to switch, ratherthan give up milk. I hope it will encourage the dairy industry to promote milk in its mosthealthful form -- as fat-free skim and low-fat 1%. ”Virgil Brown, M. D.Director, Division of Arteriosclerosis and Lipid MetabolismEmory University School of Medicine“Milk as a beverage is only healthfully nutritious if it is skimmed or 1%. ”Henry Blackburn, M. D.Mayo Professor of Public Health, Division of EpidemiologyUniversity of Minnesota9

“These good results reflect the potential to stimulate healthful nutrition changes using atargeted, simple, important message which is disseminated in a multifaceted campaign. Thisgood news will stimulate many community groups to follow the West Virginia lead and ‘cando spirit’ to reduce satur ated fat intake, which raises blood cholesterol levels more thananything else in the diet.”Claude Lenfant, M. D.Director, National Heart, Lung, and Blood InstituteNational Institutes of Health“This campaign proves that advertising works just as well for healthy eating as it does foreverything else. The low-fat milk campaign is a great step in the right direction.”Marion Nestle, Ph. D., M.P. H.Professor and Chair, Department of Nutrition and Food StudiesNew York University“Congratulations on launching the national campaign to get Americans to switch to 1% or(preferably) skim milk. This should be looked at as one important part of the goal to lowerthe still-high intake of fat, saturated fat, and dietary cholesterol in the American diet.”Jeremiah Stamler, M. D. and Rose Stamler, M.A.Emeritus Professors, Northwestern University Medical School“I was very impressed by the results.”Ernest L. Wynder, M.D.President, American Health Foundation“I applaud CSPI’s very simple and nutritionally sound approach to improve the nation’shealth. When people get used to the texture of nonfat milk, they can’t believe that they everpreferr ed the taste of artery-clogging whole or 2% milk. ”Robert PritikinDirector, Pritikin Longevity Center10

Quotes from community members about 1% Or Less“The campaign let the public know that they don’t have to sacrifice taste to reduce their fatintake.”Frederick Smart, Bridgeport, WVThe message of the campaign “was simple, clear, and easy to understand. ”Lou Ann Nicholas, Nutter Fort, WVI poured 1% milk into a 2% gallon jug until I was sure that my family was hooked on 1%.Then, I left it in a 1% jug. At the reaction ‘YUCK,’ I told them that they had been drinking itsince the beginning of February. That did that!”Ceffie Haught, Bridgeport, WV“I’ve seen a lot of programs for supermarkets, but this was one of the best.”Danny Thomas, Owner of Foodland of RosebudClarksburg, WV“What a little thing to do to help impr ove my health.”Lisa Hardman, Clarksburg, WV“I’ve switched to skim milk as a result of the campaign. The taste is the same and I can useless fat in my diet.”Reverend Kurt Busick, Clarksburg, WV“My wife and I both switched from 2% milk to skim. We also started watching the fat contentin all the other foods we buy. We switched to leaner cuts of meat. As a result, we have lostweight, feel better, and, when checked in March, our cholesterol and my triglycerides werelower.”Larry Rogers, Clarksburg, WV11

Chapter 2: Getting Startedcommunity’s needs. Thus, the Handbookdescribes a range of program options toallow you to plan the campaign that bestmeets the needs of your community, yourtarget audience, and of course, yourbudget. No campaign director shouldneed to read the entire Handbook. It isdesigned to be a smorgasbord from whichyou choose programs.How to use the 1% Or LessHandbookThe 1% Or Less Handbook describes howto plan, implement, and evaluate acommunity-wide, nutrition-educationcampaign. Whether you are a novice or aveteran in community organizing, theHandbook provides information on how topromote 1% and skim milk in yourcommunity.Part 2: Materials includes model letters,speeches, press releases, fliers, fact sheets,evaluation forms, contest guidelines, andother materials. You need only review thematerials for the programs which you planto conduct.The Handbook could be used to plan acommunity-wide program or to conductprogramming in a single communitysetting, such as a school, super market, orworksite. For example, a worksitewellness director could use chapter 8 todesign a nutrition-education progr am forher employees or a local Heart Associationcould use chapter 6 to conduct a 1% OrLess program in cooperation with asupermarket. A campaign could bedirected by an individual or a committee.The Handbook refers to the person withprimary r esponsibility for planning,implementing, and evaluating a 1% OrLess program as the campaign director.The materials in part 2 can be 1) used asthey are, 2) modified to fit the individualneeds of your progr ams, or 3) serve asmodels for materials you develop. Weencourage you to be creative and recognizethat the enclosed materials will not fit theneeds of all communities. However, wealso know how much time and money ittakes to develop and test new materials.For example, even a letter invitingvolunteers to join the campaign can takeseveral hours to wr ite and edit. We haveprovided as many model materials aspossible to allow you to focus your timeand energy on the challenges ofimplementation and on tailoring pr ogramsNo single communication channel can reachall community members. Neither can asingle program approach meet each11

a blue ribbon panel of communityleaders to support and ser ve asresources to the campaign. Recruit volunteers to join a Nutr itionAction Council to help set up andimplement campaign activities.to your target audience. We hope they willsave you time and money.Designing a campaign tomeet the needs of yourcommunity Set up a Speakers Bureau -- healthprofessionals trained to givepresentations on nutrition and/ orconduct milk taste tests at worksites,schools, and other communitylocations.The channels for communication describedin this Handbook include advertising, newsmedia, supermarkets, sch

the still-high intake of fat, saturated fat, and dietary cholesterol in the American diet.” Jeremiah Stamler, M.D. and Rose Stamler, M.A. Emeritus Professors, Northwestern University Medical School “I was very impressed by the results.” Ernest L. Wynder, M.D. President, American Health Foundation

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