Testing the Feasibility of Using Music to Communicate Nutrition Literacy,
Physical Activity Promotion and Obesity Prevention Concepts
While, there have been several health literacy campaigns implemented to address public obesity and other health disparities, people in underserved or economically depressed regions of the country remain less aware of the health risks of obesity, and, there remains a great requirement for nutrition education and wellness campaigns that equip at-risk populations with additional health maintenance knowledge and skills. Recently, the USDAawarded an SBIR grant (2010-33610-20915) to FutureSoft, Inc./Positive Records (A California corporation that specializes in educational multimedia production) to evaluate the feasibility of producing a music-based nutrition literacy, physical activity promotion and obesity prevention program. The results of the evaluation indicated that a music-based approach to nutrition education is not only feasible, but preferable to a target population of elementary school students, their teachers and their parents. The primary objective of this project was the development of a HIP-HOP/Soul MUSIC program that communicates nutrition literacy, physical activity promotion and other obesity prevention concepts to adolescent African Americans youths and their families. This objective was achieved through the production of the Groovy Pyramid “Conversation B” (Nutrition Literacy, Physical Activity Promotion and Obesity Prevention Music Program). The 13 song program featured an engaging mix of up-tempo and mid-tempo selections that highlighted the health benefits of eating whole grains, fruits and vegetables, drinking low-fat milk, and daily physical exercise. In addition, the Conversation B” program lyrics encouraged the consumption of lean meats, small meal portions and limited unsaturated fat intake. The music program also introduced the basic elements of the Nutrition Facts Label and included song tributes to existing childhood prevention programs such as Fuel Up to Play 60, Small Steps, Rethink Your Drink and Let’s Move.
In addition to demonstrating the feasibility of producing a music-based nutrition literacy messaging product, the project’s research goals was also to generate qualitative data that is useful in evaluating the potential outcome of implementing the music-based messaging nutrition education model. To that end, the project implemented a music-based School Wellness Support program at two Los Angeles area elementary schools: Ambler Avenue Elementary School and Annalee Avenue Elementary School. Both schools are located in Carson, California and are part of the Los Angeles Unified School District which comprises 565 elementary schools. Ambler Avenue Elementary School is a magnet school that serves 550 students in grades K-5. Seventy nine percent (79%) of the students enrolled at the school are African American, and sixteen percent (16%) are Hispanic, two percent (2%) are White and (1%) are Asian/Pacific Islanders. Annalee Avenue Elementary School serves 400 students in grades K-5. Ninety-two percent (92%) of the students enrolled at the school are African American, and five percent (5%) are Hispanic, one percent (1%) are White and (1%) are Asian/Pacific Islanders. In 2009, both schools had over 69% of students eligible for free or reduced price lunch programs.
The School Wellness Support program implemented by this project began with the Teacher Pre Implementation Assessment Survey. Ten teachers participated in the survey. The objective of the survey was to solicit a pre-exposure assessment of the school’s current wellness program from the primary gatekeepers for nutrition and fitness education. The survey instrument asked the teachers to rate how effective their school’s current obesity prevention and nutrition program is in communicating with students. The teachers rated their existing program on the following set of communications characteristics:
- Identifies responsible health behaviors
- Communicates information that parents can utilize at home
- Communicates in a way that children understand the information
- Provides information in an engaging and fun manner
- Demonstrates ways that children can make healthy choices
- Demonstrates how children can achieve positive results
The survey also asked the teachers how they felt overall about the concept of the music-based nutrition literacy, physical activity promotion and obesity prevention, what other elements they thought should be incorporated into the program.
Based on the ratings of provided, the teachers felt that their school’s current programs were inadequate. The teachers at both schools were enthusiastic about the overall concept of using to music to deliver obesity prevention, physical activity, and nutrition education to the students, assigning ratings of (10, and 9.68) respectively to this category and they suggested that the songs included on the program could not only teach nutrition education, but also provide an opportunity for the students to get up and move.
The Student Pre Exposure Demographic, Music/Media Preference Survey implemented through the project collected demographic data (grade, age, gender) and student preferences (music formats and the media devices). The survey instrument also included three sample messaging questions regarding nutrition literacy and physical activity. The questions were not intended to assess actual wellness factual knowledge, but rather to provide a benchmark for projecting the potential effectiveness of the music-based messaging program produced through this project. Specifically, students were asked how many times per day they should consume low-fat dairy foods? The amount of exercise they should get per day? And, if they have ever heard of the Nutrition Facts Label?
Overall, of the 271 students who participated in the Pre Exposure survey (146 from Ambler Elementary and 125 students from Annalee Elementary) 52.4% were boys, and 47.6% were girls. The average age of the students was a little over nine years old (9.09) at Ambler and ten years old at Annalee. Across both schools, over 83% of the students identified themselves as African American, and 12.9% identified themselves as Hispanic. A large majority (95.2%) of the student preferred the “Rap/Hip-Hop” music format and over sixty percent (60.4%) liked “R&B.” Close to eighty percent (79.3%) of the students reported having a television in their home and approximately seventy four percent (73.8%) said they had a video game console.
In terms of the pre-exposure sample wellness messaging questions, about a third of the students (32.8%) estimated three times per day low fat dairy consumption. Thirty six percent (36.2%) estimated an exercise requirement of 60 minutes per day. And, approximately thirty seven percent (37.6%) had previously heard of the Nutrition Facts Label. The goal for the above set of messaging queries was to test the potential effects of the slogan messaging featured in three songs on the Conversation B program (“Three Times A Day”, “Fuel Up to Play 60″, and “The Label”). The project acknowledges that the recommended amount of daily dairy food consumption (RDA) is different for each person, and that the number of times one consumes dairy foods may not equate to achieving their respective RDA.
The project developed and implemented a Music-Based Messaging Content Exposure Model that included three main elements (Introduction Assembly, Classroom Integration, and Closing Assembly). The Introduction Assembly element involved convening students in grade-level assemblies that took place in the school’s auditorium. At the assemblies, the students were exposed to the Conversation B music content through an interactive moderator led session that lasted approximately 40 minutes. During the sessions, students were introduced to basic nutrition literacy principles, the benefits of physical activity and they were shown three animated dancing lyrics music videos from the Conversation B program. The Introduction Assemblies concluded with a question-and-answer session and each student was given a Conversation B Music CD to take home to share with their family. The teachers were provided a toolkit with learning materials to assist them with the Classroom Integration elements. The Classroom Integration element featured a set of cross-disciplinary exercises, activities and assessment tools. The exposure model culminated two weeks later with a “Listening Party Closing” school assembly that featured a summary of the program’s content and a live performance of the Conversation B music program by the Groovy Pyramid singing group.
After the students were exposed to the music content, the respective school teachers and students were asked to complete surveys to collect their feedback. Teachers were asked questions regarding their individual and classroom usage and to rate the Conversation B Music CD content/Assemblies. Nineteen teachers completed the survey and they assigned an average rating of (9.12) rating to the songs produced through the program and a rating of (9.28) to the overall concept of using to music to deliver obesity prevention, physical activity, and nutrition education to the students. The students were asked to describe and rate the Conversation B Music CD and the Assemblies. The Student Post Exposure Survey also asked the students a series of usage questions including how many times they listened to the CD and if they shared the music with others. In addition, the Student Post Exposure Survey included the same three sample messaging questions asked during the Student Pre Exposure Survey.
Two hundred and seventy one students participated in the Student Post Exposure Survey. The students assigned an average rating of (8.74) to the Conversation B music program and (8.83) to the School Assemblies. Over ninety five percent (95.2%) of the students who reviewed the music program categorized the music format “Rap/Hip-Hop” music format and over sixty percent (60.4%) thought the music was R&B. The students reported that they listened to the music program on average approximately thirteen times (13.31). The primary device used to listen to the Conversation B music program was a portable CD player with over eighty six (86.5%) percent of the students using it and almost a third of them (32.4%) used a Car CD player. More than ninety four percent (94.1%) of the students shared the music with others and almost seventy percent (68.6%) reported that they planned to listen to the music program in the future. After the implementation of the Music Content Exposure Model, over fifty six percent (55.6%) estimated three times per day low fat dairy consumption and close to fifty nine percent (58.5%) of the students estimated an exercise requirement of 60 minutes per day. Sixty six percent (66.2%) reported having previously heard of the Nutrition Facts Label after listening to the Conversation B music program.
Although several studies have reported on the general impact of nutrition literacy, very little information is known about the effectiveness of music-based nutrition literacy, physical activity promotion and obesity prevention messaging. Accordingly, this project represents an important first step in understanding the music-based messaging methodology. Additional research is warranted in order to learn more about this innovative health communications discipline. While it is not asserted that the project’s reported results have statistical significance, it is asserted that the data collected during this research does document the feasibility and potential positive effectiveness of implementing a music-based messaging program in school and community environments.