Chapter 8). Nonetheless, the committee recognizes that the behaviors associated with the obesity epidemic are widespread, and few other mechanisms are available for stimulating the required changes. Use of the mass media is the best way to reach large segments of the population. At the same time, the committee recognizes that there have been very few efforts to address the problem of childhood and youth obesity through the mass media, thus actions in this domain should be accompanied by careful and continuous monitoring and evaluation to ensure that they are doing what they were meant to do.

Finally, the committee recognizes that if a campaign is not designed with sensitivity, there may be an unintentional consequence that could increase stigmatization of obese children. Stigmatization of smokers was thought to be an effective tool for the tobacco control campaigns; however, obesity may be different. Therefore, the possibility that a campaign could increase negative attitudes and behaviors directed at obese children and youth, such as teasing and discrimination, needs to be explicitly considered in the design and development of the campaign. This should include adequate formative evaluation during development as well as surveillance, concurrent with and following campaign implementation, to detect and minimize any potential adverse effects.

Media-centered efforts must be closely linked with complementary efforts elsewhere in pursuit of the same objectives. For example, a media campaign to recommend that children walk to school might need to be complemented by a public-relations campaign to ensure that there are safe routes for walking, a campaign for reaching parents with a message that they should encourage their children to walk, and a campaign for motivating children to be excited about and interested in walking to school. Thus, media-centered efforts include not only those directed at children and youth themselves, and those directed at parents, but also those directed at policy makers. Throughout this report the committee has emphasized the central role of policy change in obesity prevention, and media-based efforts can have an important role in achieving these changes.

Policy changes occur more quickly if there is a strong social consensus behind them (Economos et al., 2001; Kersh and Morone, 2002). For example, it is worth considering the policy changes that have been important in the success of the anti-tobacco movement (Kersh and Morone, 2002; Daynard, 2003; Yach et al., 2003; see Appendix D). Restrictions on advertising, increases in taxation, and controls over smoking-permissible locations were important components of the tobacco-use decline (Hopkins et al., 2001), but these changes could be readily implemented only because a new public-opinion climate around tobacco supported them and permitted legislators and regulators to act (Kersh and Morone, 2002; Yach et al., 2003). This public opinion transformation likely resulted both from the



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