Dr. Pepper Ten: A "Manly" Campaign That Promotes Gender Stereotypes Instead of Health for Men

Yesterday while on the elliptical machine at the gym and watching ESPN (surprise! women watch ESPN), I had the displeasure of seeing the new commercial for Dr. Pepper Ten no less than five times.

Dr. Pepper Ten is a new 10-calorie drink being rolled out by the Dr. Pepper Snapple Group Inc after their client research revealed that men are hesitant to drink diet drinks because they aren't "manly" enough.

The TV commercials that I watched showed men with huge muscles driving through the jungle, shooting guns, and battling snakes. The men say things like, "Hey ladies. Enjoying the film? Of course not. Because this is our movie and this is our soda, you can keep the romantic comedies and lady drinks. We're good."

According to several online reports (e.g., the MSNBC link above), the campaign also developed a Facebook page which contains an application that allows it to exclude women from viewing content. In addition, the page includes games and videos aimed at being "manly." Several twitter users also report that the campaign encourages viewers to "rat on their friends for not being manly". If true, I have no idea how "unmanly" behavior is being reported.

My analysis:

It is great that advertisers are using focus group and other data to develop products and ad campaigns. They taught many of us in public health the importance of these strategies and we are forever grateful. However...

This campaign promotes strict gender stereotypes: Men act like this and women act like this- no exceptions! This dangerous norm contributes to serious public health problems. For example, the traditional ideology of masculinity has been explored for its relationship to negative outcomes like bullying and high risk sexual behaviors.

This campaign attempts to encourage men to drink a "healthier" soda (less calories, real sweeteners) without making them feel like they are dieting...because after all- dieting is only for women. Too bad the obesity rate is hovering between 32-35% for both men and women.

I have seen weight loss/health for men done much more effectively by other companies without insulting viewers. For example, after they saw their services being utilized by more men, Weight Watchers and NutriSystem rolled out men's programs. Weight Watchers presents strategies for making healthy choices in settings where men may find themselves socially (e.g., at a BBQ or at the bar). To reduce the social stigma around participation, they recruited strong male role models like former NFL quarterback Dan Marino. An ABC story on the companies' programs says "Calorie Counting Can Be Macho".

The strategy used by NutriSystem and Weight Watchers to reduce the stigma around healthy behaviors will be much more effective long-term than simply tricking people into being healthy.

For those readers who think I'm only offended by the campaign because I'm a woman, please see a few tweets from Tuesday night...authored by men. The first by my husband, who wrote multiple posts on Dr. Pepper Ten before I ever voiced my disgust with this campaign:

@jeff_underscore: "Dr. Pepper 10 - I think your ad campaign is insane, insensitive and sexist and unfortunately everywhere".

@sorryeveryone: ".@drpepper i really liked your soda but you know what I like more? treating women like they're human beings and letting men be themselves".

Readers: What do you think of this campaign? Do you think it will be effective in getting men to drink these "healthier" sodas?

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#NoHomos on Twitter, "50/50" looks at Cancer, Johnny Depp's Rape Comments, Chris Christie's Weight, and Steve Jobs: What Am I Reading This Week?

Whew- it has been a busy week for Pop Health! Here are the top 5 stories I've been reading:

1. Twitter is no place for #NoHomo: Should Twitter take a more proactive stance regarding hate speech that can result in trending topics?

2. "50/50"- A Hollywood movie takes on cancer: Cancer has been a theme in many movies (e.g., "Funny People") and TV shows (e.g., "The big C" on showtime)- how does this movie compare?

3. Johnny Depp offers apology for rape remarks: Depp offers an apology for comparing being chased by paparazzi to being raped. Forgivable?

4. Chris Christie's Weight- Big problem or none of our business?: Although Gov Christie has recently announced that he will not run for President in 2012, the conversation continues about his weight and its influence on his ability to be a successful Governor or President. What do you think?

5. Steve Jobs and Pancreatic Cancer: There have been many stories about the death of Steve Jobs and the contribution of pancreatic cancer to his passing. I thought Celebrity Diagnosis did a nice job of guiding readers through his diagnosis.

Please use the comment box to tell me what you think about these stories and about others that you are reading this week!

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Will New Ads in Georgia "Stop Childhood Obesity" or Increase Stigma and Bullying?

On Friday's Today show, there was an interesting analysis of a new campaign from the Georgia Child Health Alliance (GCHA) aimed at reducing childhood obesity. According to the GCHA website, the Warning: Stop Childhood Obesity media campaign "is part of a large-scale public awareness campaign designed to educate Georgians on the childhood obesity epidemic facing our state. Backed by market research, the campaign’s warning messages about obesity are developed to reach parents and children using communication vehicles such as billboards, television, radio and more".

From the Today show segment (which featured the campaign's Director, a child actor featured in the ads, and a child psychologist) we learned that this media campaign is part one of a three part campaign. The three parts were briefly outlined:

1- Raise awareness about childhood obesity; letting kids voice their struggle in their own words.
2- "Activate"- focus on healthy eating and activity
3- Focus on real solutions

While the GCHA outlines their strategic mission for this campaign, they are hearing some major objections to their approach and it continues to grab national headlines. The major concerns voiced by objectors such as Rebecca Puhl (a weight discrimination expert from Yale University), are that the ads will increase stigma for overweight kids (which could increase their experience of bullying) and that the ads will be ineffective due to their fear-based approach. In my review of the ads, I have mixed (mostly negative) feelings about their development and implementation:

• Strike One: The goal of this campaign is listed as "raising awareness". These may be my two least favorite terms in all of public health. "Raising awareness" is too vague and does not lend itself to being evaluated. In actuality, campaign developers usually want to "increase knowledge" or "change perceptions" or "change behavior" (e.g., calling the 800 number on the screen). These are all things which can actually be measured and should be stated more clearly.

• Strike Two: When the Today show asked the Campaign director about the audience for these ads, he replied "parents, kids, and educators". Again, this is way too vague. Your message and call to action (i.e., what you want the viewer to do after watching the ad) would be completely different for each of those audiences. For example, you may want educators to reach out to the parents of overweight kids in their classes or you may want kids to tell an adult if they are being bullied about their weight. These messages need to be tailored to each audience.
  

• Strike Three: These ads definitely fall into the "fear-based" category. As you watch them, the ads read "WARNING" in bold red letters and you hear a "boom" (kinda like on "Law & Order) as the statistics run across the screen. As I have mentioned in previous blog posts, fear-based approaches have been found to be ineffective in other areas of prevention (e.g., alcohol and other drugs).

• In terms of redeeming factors, it does seem that the campaign was developed using formative research which included focus groups with overweight kids. The results of these focus groups were used to develop the dialogue read by child actors in the ads so that it would be "in their words". If kids are the audience for these ads, then the age appropriate priorities and dialogue (with the inclusion of child actors) is positive. From health behavior theory (e.g., Social Learning Theory), we know that kids will respond better if they relate to those in the ads.
  

Of course, it is unclear if they also focus group tested the ads and billboards after initial development, before they were rolled out. It is also unclear how they are being evaluated and what the ultimate goals are (beyond "increased awareness"). I'll be interested to see parts two and three rolled out and hope to include follow up thoughts here on Pop Health.

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Marie Claire Blogger vs. Mike & Molly: A "Heavyweight" Fight

Last week a blogger for Marie Claire Magazine named Maura Kelly posted an article called, "Should 'Fatties' Get a Room? (Even on TV)?" The post is focused on a new fall sitcom for CBS called "Mike & Molly". I must disclose that I have not watched this show, but have read that it centers on a couple that meets at an Overeaters Anonymous Group. Ms. Kelly takes a strong position that this show is "promoting obesity" and is grossed out by having to watch two obese people make out (or do anything else, like walk across a room).

As you can imagine, this post has been met with quite a reaction, including 3,195 reader comments (as of tonight) that prompted Ms. Kelly to post an update (aka apology). The update apologizes to those readers that were offended (many of which state that they have since canceled their Marie Claire subscription) and offers that perhaps her strong reaction to these overweight actors comes from her own history as an anorexic. The gist I get from the comments, is that most readers do not feel the apology is sincere and expected a better response from Marie Claire (that would include firing Ms. Kelly and/or making it clear that they will not support this type of discrimination). There has also been a strong response from the celebrity community, including Sharon Osborne on "The Talk" who said that she was appalled and wondered about what Ms. Kelly would think of her. Sharon admitted that she's 30 pounds overweight...should she not be allowed to kiss her husband or walk across the room?

According to the Centers for Disease Control and Prevention (CDC), 34% of adults are overweight and about the same percentage are obese. If approximately 70% of our adult population is overweight or obese, why don't we have more characters that accurately reflect what people actually look like and the challenges that they face? Hasn't there been some effort to portray more diverse characters in other ways (e.g., race and ethnicity)? Why would being overweight be so offensive to the viewing population? And is Mike & Molly really the first show to do this? Growing up, I was a fan of the sitcom "Roseanne" (1988-1997). The primary couple on the show (Rosanne Barr and John Goodman) were very overweight and struggled quite openly with weight, diet, and exercise on the show. Perhaps my memory is fuzzy, but I never remember hearing that viewers were horrified by these characters showing affection on the show.

Ironically, as I was getting ready to put this post together today, I caught the Oprah show. She had on Portia Di Rossi who discusses her battle with Anorexia and Bulimia in her new book "Unbearable Lightness".

Portia spoke about her breakout role in Ally McBeal in the 1990s. Many of you may remember the media headlines at that time calling the three female leads "Scary Skinny" (which they were- Portia was down to 82 pounds at one point). Ironically, she specifically discussed her fear about a scene where she seduces her boss in her lingerie in the law office. Although she was skeletal and sick looking, did we hear from viewers or writers that they were "grossed out" to watch her make out with her boss on the show?

So what is best for viewers? What messages regarding "normal" should we be sending to viewers? If actors are too skinny, the concern is that the image is not realistic and it is causing young girls to have eating disorders trying to achieve this ideal. However, when a show like Mike & Molly is showing characters that accurately represent 70% of the population, there is also controversy. From a public health perspective, I would say that characters should accurately reflect the viewing population- people tend to respond to people that they can relate to. If you are creating a health communication product (e.g., poster or brochure), you test it with the target audience to make sure that they connect to the images. If you are concerned about "promoting obesity", then have the characters modeling healthy behaviors. For example, Mike & Molly are attending an Overeaters Anonymous Group, which means they are taking steps to improve their lifestyle.

I for one, would be very happy to see more realistic characters on television. I would also like to see research on how those characters can be used as a health communication tool to promote positive body image and health behaviors among the viewing population.

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Talkin' Bout A Revolution...Jamie Oliver is much louder than a whisper!

So I just finished watching the premiere episode of "Jamie Oliver's Food Revolution". It is a new show on ABC that chronicles the journey of English chef Jamie Oliver as he tries to change the eating habits of residents in Huntington, West Virginia. Huntington was recently crowned the most unhealthy city in America.
It is obvious that Jamie has good intentions. He has left his family for several months to work on this project. He is especially concerned about the quality of food being served in the Huntington schools. However, my reaction to the first episode was "No, no, no! Stop what you're doing and talk to these people first!"

The most important part of any public health intervention is getting to know the community you are working with. The worst thing you can do is come in as an "outsider" and start barking orders. Some questions you should ask before getting started are: How does this community operate? Who makes the decisions? What are some of the barriers to serving fresh food in schools? What are the USDA guidelines? (which Jamie knows nothing about) Who are the individuals you want/need to get on board with your idea? How do the parents feel about their children's eating habits? How can you get their buy-in? What would be a realistic timeline for assessment/buy-in before trying to implement change?

Jamie went about this all backwards (which may very well have been to increase drama for a TV show, but it is still a great example of "what not to do"). His first day in town he was told he was viewed as an "outsider" by the trusted radio host...and still proceeded to go into the elementary school and lecture the chefs on how disgusting the food is (after only observing them for one day). And he's surprised he's getting push back on his efforts?! The only small victory he has is creating a partnership with "Pastor Steve" at the local Baptist church. Steve is a trusted leader in the community and knows the families and their challenges very well.

Too bad Jamie did not look to better models of this kind of community effort. Shape Up Somerville (Somerville, MA) began as a community based research study at Tufts University targeting 1^st through 3^rd graders in the Somerville Public Schools. Today there is Coordinator working on active and healthy living programs supported by the Health Department and a Taskforce that is a collaboration of over 11 initiatives and 25 stakeholders involved in working on various interventions across the city. Program components include a focus on the school lunch program, local restaurants, walk ability and safe routes to school, etc. (I'll give a shout out here to one of my public health heroes- Julia Bloom- who helped Tufts bring this model to more rural communities across the country!)

Shape Up Somerville represents a strong program that began with a strong base. The original program engaged key stakeholders and did not try to change the community without first finding out how it worked. The community and parent outreach were an obvious key to success...where that aspect is basically forgotten in the "Food Revolution". Jamie just seems like one man on a mission to change. At the end of the episode Jamie is visibly upset and says "they don't know why I'm here". Yeah- that's because you're an outsider lecturing them on how they should raise their kids!

I'll probably watch the second episode where he actually starts to engage the community...how about you?

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