CEL Assignment #2: Final Project Sheet (15%)

You will notice that this sheet is very similar to your initial projects sheet,
although some additional sections have been added, so please read carefully
and update accordingly. Please keep your answers constrained to 5 pages.
You may alter the length of any given section, and you may delete these
instructions, but the total length must remain at 5 pages. A 6th page for
references is ok.
SECTION 1: Project Overview
1. Group members:
Lisa Pilatzke
Brittany Hannan
Andrea Klein
Mandeep Kooner
2. Selected topic area (please circle):
a. Physical activity
drinking

Healthy eating

Responsible

3. Proposed strategy and goal of your strategy (i.e. what is the

specific objective of your strategy?):
To implement a nation-wide policy that restricts unhealthy food advertising to
children aged 2 to12 years old in Canadian networking television stations
through government regulation.
4. Target audience: Children; 2 12 years old. According to the
Broadcasting Code for Advertising to Children, the definition of a child under
their code is anyone under the age of 12 (ACS, 2015).
4. Description of budget:
An Australian study analyzed the cost-effectiveness of implementing a ban on
energy-dense, poor nutrient foods to children aged 5-14 year olds during
peak viewing times for children (i.e. morning for 1-2 hrs & afternoon/evening
for 5 hrs). Researchers concluded that the total cost of the nation-wide ban
would be about $130,000AUD, with 100% of the cost coming from
government regulators (Magnus et al., 2009), which currently equates to
around $122, 400 Canadian dollars. Furthermore, researchers estimated
about $0.33AUD and $3.70AUD to be the cost per unit BMI saved and per
disability-adjusted life year saved, respectively (Magnus et al., 2009).
5. Approximate timeline:
6. Key community partners who should be considered and how you
will engage them and/or build on their strengths.
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The main community partner that we will reach out to would be the
Ontario Public Health Association (OPHA). This is because they have existing
programs and networks running that are looking into specific public health
issues, and one particular group is looking to ban commercial advertising to
children. Their mission is to ban harmful advertising to children under the age
of 13, which perfectly aligns with our goal, and while they do look at different
types of harmful advertising, one that they outlined was unhealthy food
advertisements. We can build on their strengths by adding all of our specific
research into unhealthy food advertisements, which will help them to
advance quicker in their goal of banning all advertisements.
Two other partners that we would approach would be the Heart and Stroke
Foundation and Sick Kids Hospital, whose advocacy work already has
provincial wide impacts. These are groups that already have a province wide
impact, and we would engage them by emphasizing the impact that food
advertisements have on childhood obesity. These organizations already have
an interest in lowering this current epidemic so we would build on that with
our new approach to helping lower childhood obesity.
For specific partners in the WDGPH area we would reach out to Growing
Great Kids and the Childrens Foundation of Guelph and Wellington. These
two groups are local advocates for healthy eating and habits of children and
we would engage them by expressing our common interest of promoting
healthy living for children and add to their strengths by bringing detailed
research and a plan to implement the policy.
The last partner that we would seek out for support would be the
Advertising Standards Canada Board of Directors. We would bring our
research and proposal to present to this board because if we gained their
support or even just an interest from some of the members, they could then
use their influence on the CRTC to put our policy into the right hands. We
would engage the board by presenting our research so that they see the
importance of advertisements on children and how it can greatly affect their
decisions, especially since we are dealing with both high childhood obesity
rates and high screen time rates. We would make sure they knew this
problem hits close to home and very important.
7. Rationale for how your choices consider the specific needs of
WDGPH:
A NutriStep screening tool was distributed to kindergarten students in
February and March in 2014 to obtain information on student eating habits
(WDGPH, 2014). The survey revealed 35% of the respondents ate in front of
the TV which, can lead to unhealthy food choices and increased risk of
obesity (WDGPD, 2014). A third of respondents ate vegetables once a day or
less and almost half ate 2 servings or less of fruit a day (WDGPD, 2014). In
addition, almost a quarter of respondents reported eating fast food one or
more times per week (WDGPH, 2014). Lastly, almost a third of the
kindergarten students are overweight or obese according to a Well-Being of
Children Ages Birth to Six Report Card (WDGPD, 2014). Furthermore, a 20112

2012 Youth Report Card for WDG grade 7 and 10 students revealed
approximately 45% had chocolate or candy once a day or more and 45% of
grade 7 students consumed pop or a sugary drink at least once a day
(WDGPH, 2014). Hence, combating eating habits at a younger age may lead
to better eating behaviours later on.
SECTION 2: Support For Strategy
1. What evidence is your strategy based on? (Please discuss a
minimum of 8 sources). Be sure to consider evidence from the
grey literature.
A study in northern California analyzed the effects of advertising of food
products on preschool childrens food choice preferences. The study took 46
children, aged 2-6 years, and split them into two RCT groups; childrens
cartoons with or without 30 second embedded food advertising commercials
(Borzekowski & Robinson, 2001). Researchers found that the children
exposed to embedded food commercials were significantly more likely (p<
0.01) to choose the products that they saw advertised (Borzekowski &
Robinson, 2001). This study shows how easily influenced children are to
advertised food products, therefore, limiting these advertisements to children
may be beneficial. Furthermore, a study by Chamberlain, Wang and Robinson
in 2006, which looked at self-reported requests for products (food, drinks and
toys) and screen time of 368 grade three children over 20 month span, found
that screen time was significantly related to childrens requests for food and
drinks, over toys, regardless of sex, language, and socio-economic status of
the parents. As well, studies done on the effects of food advertising and food
consumption in children show that there is a direct correlation between food
advertising and the foods that children ask their parents for (Harris,
Pomeranz, Lobstein and Brownell, 2009). It has been identified that children
are more likely to consume foods that are most recently advertised to them
(Harris, Pomeranz, Lobstein and Brownell, 2009).
A 2011 study by DHar and Baylis, investigated the effect of the Quebec
ban on advertising to children by comparing the consumption of fast-food
between 1984 to 1992, among those effected by the ban in Quebec and
those not effect by the ban in Ontario, in both French and English-speaking
households with and without children (Dhar & Baylis, 2011). Detailed
analyses showed that French-speaking households (FSH) in Quebec were
12.3% less likely to purchase fast-foods compared to FSH in Ontario, although
there was no difference in fast-food consumption between English-speaking
households (ESH) among the two provinces and between households without
children (Dhar & Baylis, 2011). Additionally, households with children in
Quebec that had access to cable were 13% more likely to purchase fast-food
(Dhar & Baylis, 2011). Researchers estimated the effect of the ban on
consumption of fast-food among French-speaking households with children in
Quebec to be a savings of $88.3 million, with an estimated reduction of 9-23
billion less consumed calories from fast-food per year (Dhar & Baylis, 2011).
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These findings highlight the benefits of advertising bans to children,

particularly in consumption of fast-food.
Although alternative media outlets has increased over the years, it is evident
that television is still the most prominent outreach for marketing. In the
United States in 2009, $375 million was spent on children (2-11 years old)
specific advertising through television in comparison to new media outlets:
internet, websites, word of mouth and viral marketing, spent $122.5 million
(2012). Furthermore, advertising for youth (aged 12-17) was slightly less
($364 million) and therefore, it appears that companies try to target the
younger children more than adolescence (2012). This provides us with the
argument for why we have specifically targeted TV advertising in our strategy
as opposed to other media outlets in children aged 2-13 years old.
Currently advertising in Canada is monitored by three self-regulatory
codes; the Advertising Code Standard (ASC) administers the ASC code and
Broadcast Code for Advertising to Children and the Canadian Marketing
Association administers the Code of Ethics and Standards of Practice (Jeffrey,
2006). There are current flaws and holes in the present codes that are used
to monitor advertising in Canada (Jeffrey, 2006). For example, in the
Advertising to Children Code, it does not forbid that commercials are not
allowed to appear in a format or style that masks the intent of the
commercial but this is a part of the regular ASC code (Jeffrey, 2006). Thus,
allowing commercials, advertised to children, to hide their intent is deceiving
to children. Furthermore, the only prosecution tool that ASC has is publishing
decisions, thus, they are not allowed to enforce punishment on violations that
occur to the code (Jeffrey, 2006). It appears that the ASC does not have a lot
of control over enforcing the code and that there needs to be stricter
regulations. The Harris et al. review also supported the need for stricter
regulatory authority (2009). Even another systematic review showed
evidence that some reduction is seen in childrens exposure to unhealthy
foods when strict government regulation is in place, compared to selfregulation (Galbraith-Emami & Lobstein, 2013).
2. How does your strategy consider health equity and the social
determinants of health?
This strategy considers health equity and social determinants of health
because research has shown that children whose parents are more educated,
and therefore, more likely to be of a higher socio-economic status watched a
considerably less amount of hours of TV (Christakis et al., 2004). Due to a
correlation of TV watching and obesity in youth (Janssen et al., 2004), this
strategy would help to allow for obesity rates in lower socio-economic
families to decrease, therefore, equal opportunities for all to choose/request
healthy foods.
SECTION 3: Action Plan!

1. How will your strategy be operationalized? Discuss all necessary

steps in detail.
First, we will need to create a group of people who will come together each
week to help build a strong case in order to bring the policy forward to the
CRTC and the Canadian government. This team will be comprised of two
WDGPH public health staff, two dieticians, a nurse and a physician. The main
objective of this group of health professionals is to gain the approval and
support of the key community partners mentioned above. The additional
support of the non-government groups, especially the dieticians, physicians
and nurses, and Canadian Advertising Standards Board of Directors is to
develop clear stipulations of the policy (i.e. nutrient profiling, fines for
violation, and outline of what types of advertisements to children are
banned). Once this has been successful and we have got the key partners on
board, the next step will be to focus on social media campaigns in order to
get the public talking about the policy; and ideally win the publics support.
These social media campaigns will utilize numerous platforms such as
Facebook, Twitter, and Youtube. It has been reported that Facebook would
take less than 3 months to rely a message to 50 million people compared to
38 years for radio and 13 years for television (Schein et al., 2010). These
social media platforms are unique because we are able to reach a large group
of people quickly with very little cost, as well, it enables conversation with
the public, including feedback (Schein et al., 2010). Also, as part of our social
media campaign we will get local and national news stations (i.e. CTV and
CBC) to interview our staff members about the policy to further increase
awareness. Once adequate support and public awareness of the policy has
been met, we will then bring our policy to the CRTC and to the Canadian
government. These are the two governing bodies that have the authority to
either accept or deny the policy in Canada. Once the policy has been
accepted, government regulation will then be able to successfully restrict
unhealthy food from childrens advertising, with legal consequences.
2. What are the key strengths and limitations of your strategy?
What steps have you put in place to minimize foreseeable
challenges?
One of the strengths of this policy is that the government will regulate it.
We would propose that it should be regulated because it appears that even
with the current codes on childrens advertising that this is the area that ..
Another strength of this strategy is that it is very cost-effective, as shown in
the Magnus et al. 2009 Australian study. An approximate estimate of over
$120,000 is very affordable on a national level. In addition, the fact that the
policy will be implemented at a national level will result in a more effective
policy than just focusing provincially or municipally because it will have a
wider-reaching effect, as noted in the Dhar and Baylis study.
Some of the key limitations of this strategy are the fact that children have
access to a large variety of media outlets in todays society (i.e. internet,
video games, accessibility of U.S. TV stations through cable & satellite),
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however, we have proven through the 2012 study by that TV advertising to

children is still the largest funded media form by companies compared to all
other forms. Another challenge may be to convince the government that
unhealthy eating in children is a public issue versus a private one, a seen in
the review article by Harris et al. in 2009. In order to combat this, our
strategy will first look to get enough community partners and public support
through our social media campaign and partnerships that will convince the
Canadian government that the population wants to see change on this issue.
Also, as discussed previously, holes in the current self-regulatory codes of
advertising are an issue that will prevent this policy from being successful.
Therefore, our policy aims to provide stricter regulations through the
government, including nutrition profiles for better-for-you and worse-foryou foods (Harris et al., 2009), as well as greater penalties for violation.
Specifically, a South Korean study noted a $10,000 fine was perhaps not
steep enough for full compliance, when the average cost for prime time
advertisements were $15,000 (Kim et al., 2012). Therefore, matching or
going above the cost of advertising may be beneficial. This may also help
with the expected backlash from the food advertising industry. As well, the
push from community partners and the public (consumers) through social
media campaigns will discourage companies from fighting this policy.
3. How have you designed your project to be sustainable? (consider
financial, personnel etc.)
This strategy is very sustainable because we are utilizing resources that are
already in place (i.e. partnering with organizations, creating a team of public
health promoters from regions across Ontario that will help to advocate for
the policy). Additional time spent promoting this policy and advocating from
it will be the main requirement from these personnel. Also, as seen in the
Australian study of cost-effectiveness, the overall health benefits of
implementing the ban far out-weigh the total estimated cost, that the country
would eventually save money from evading the potential health-care costs of
the current path (Magnus, et al., 2009). In addition, a threshold analysis
concluded that even if almost all the BMI benefits were lost, the ban would
still be cost-effective and continue to save money (Magnus et al., 2009).
Therefore, this strategy has been shown to be very cost-effective and
sustainable financially.
4. How will you know if your strategy is successful? (HINT: this
should link back to your project goal/objective!)
5. How has your project improved in response to the feedback that
you received (either from WDGPH or instructor/TA feedback)?
Our project improved immensely since receiving feedback. Our initial plan
was to start locally in local TV stations and print advertisements in the area,
however, it was outlined to us that a broader scope for this policy would be
much more effective, therefore, we have changed the policy to reach within
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all of Canada. In addition, we were able to identify a clear path to focus the
process of implementation that also utilized local resources (i.e. staff) in
WDGPH and who to partner with, whereas previously, we were overwhelmed
with how to go about implementing a policy and unsure where to start.
References:
Borzekowski, D. L. G., & Robinson, T. N. (2001). The 30-second effect: an
experiment revealing the impact of television commercials on food
preferences of preschoolers. Journal of the American Dietetic
Association. 101(1): 42-46.
Chamberlain, L. J., Wang, Y., & Robinson, T. N. (2006). Does childrens screen
time predict requests for advertised products? Cross- sectional and
prospective analyses. Archives of Pediatrics and Adolescent Medicine.
160(40): 363-368.
Christakis, D. A., Ebel, B. E., Rivera, F. P., & Zimmerman, F. J. (2004)
Television, video, and computer game usage in children under 11 years
of age. Journal of Pediatrics. 145(5): 652-656.
Galbraith-Emami, S., Lobstein, T. (2013). The impact of initiatives to limit the
advertising of
food and beverage products to children: a systematic review.
International
Association for the Study of Obesity. 14: 960-974.
Harris, J. L., Pomeranz, J. L., Lobstein, T., & Brownell, K. D. (2009). A crisis in
the
marketplace: how food marketing contributes to childhood obesity and
what can
be done. Annual Review of Public Health. 30: 211-225.
Janssen, I., Katzmarzyk, P. T., Boyce, W. F., King, M. A., & Pickett, W. (2004)
Overweight and obesity in canadian adolescents and their associations
with dietary habits and physical activity patterns. Journal of Adolescent
Health, 35(5): 360-367.
Kim, S., Lee, Y., Yoon, J., Chung, S. Lee, S., & Kim, H. (2012). Restriction of
television food
advertising in south korea: impact on advertising of food companies.
Health
Promotion International. 28(1): 17-25.

Magnus, A., Haby, M. M., Carter, R., & Swinburn, B. (2009). The costeffectiveness of
removing television advertising of high-fat and/or high-sugar food and
beverages to australian children. International Journal of Obesity. 33:
1094-1102.
Schein, R., Wilson, K., Keelan, J. (2010). Literature review on effectiveness of
the use of
social media: a report for peel public health. Peel Public Health. pp. 163.
Tirtha Dhar, Kathy Baylis (2011) Fast-Food Consumption and the Ban on
advertising
Targeting Children: The Quebec Experience. Journal of Marketing
Research: October
2011, Vol. 48, No. 5, pp. 799-813.