Executive Summary

Type 2 diabetes is a global epidemic that disrupts how the body metabolizes glucose into energy, leading to complications such as heart disease, blindness, and kidney failure. An individual’s risk of Type 2 diabetes increases drastically with poor lifestyle decisions such as an unhealthy diet and lack of exercise. As a result, organizations in New Zealand, such as the Child Obesity & Type 2 Diabetes Prevention Network, are seeking to implement diabetes awareness campaigns in an effort to educate the public about the preventative nature of Type 2 diabetes and ultimately lower the prevalence of the disease.

Health awareness campaigns can utilize numerous channels of outreach, such as television, radio, billboards, posters, magazines, newspapers, and Internet. Campaigns utilizing these media outlets can influence the target audience either directly or indirectly. However, barriers such as the knowledge gap, self-positivity bias, and temporal orientation may prevent a campaign from making the intended behavioral impact on its audience. Proper choice of strategies such as campaign format and message framing can help overcome the barriers that may hinder the success of a campaign.



The goal of this project was to aid the Child Obesity & Type 2 Diabetes Prevention Network in assessing the current knowledge among the general New Zealand population and providing recommendations for an awareness campaign tailored towards their society. The campaign itself would aim to raise awareness about Type 2 diabetes and its risk factors in order to prevent future cases of the disease. As part of our assessment, we administered a questionnaire on Type 2 diabetes knowledge to 401 people in the greater Wellington, New Zealand, area and interviewed three local organizations about health campaigns aimed at altering deleterious behaviors. To attain the project goal we accomplished three objectives:

  1. Assess the existing levels of understanding and attitudes towards Type 2 diabetes in the general population of the greater Wellington, NZ, area

  2. Identify the most successful strategies utilized by current diabetes campaigns in New Zealand for altering behaviors and preventing an increase in Type 2 diabetes

  3. Identify the most successful strategies utilized by public health campaigns aimed at altering deleterious behaviors in New Zealand

To assess the current knowledge and attitude towards Type 2 diabetes we developed a questionnaire with the assistance of our sponsor, the Child Obesity & Type 2 Diabetes Prevention Network. We administered 401 questionnaires in the public areas of Central Wellington – Cuba Street, Wellington Railway Station, Civic Square and Midland Park at Lambton Quay – as well as the outer suburbs – Lower Hutt and Porirua – to obtain a sample population with diverse demographics. The questionnaire was designed to gather information regarding the population’s gaps in knowledge and attitudes towards Type 2 diabetes as well as healthy eating and temporal orientation – the way an individual views the outcomes of his or her actions.

To identify the most successful strategies utilized by health campaigns regarding changing lifestyle behaviors in New Zealand – objectives two and three – we interviewed representatives of various health awareness organizations including Diabetes New Zealand (DNZ), Health Promotion Agency (HPA), and Quitline. We interviewed DNZ to gain insight into past diabetes campaigns in New Zealand. We interviewed HPA to obtain information about nutrition and fitness campaigns. We interviewed Quitline about their anti-smoking campaigns to gain insight into successfully reaching out to the public.

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The questionnaire evaluated respondents’ attitudes towards the seriousness of Type 2 diabetes, healthy eating, and the consequences of the respondent’s actions. A majority of the New Zealand residents who responded to our questionnaire believed that Type 2 diabetes is a serious condition. A large majority – 98% – of them had a positive attitude towards healthy eating and believed it is essential to their well-being. Sixty-five percent of respondents were future-oriented, meaning that they consider the long-term consequences of an action compared to primarily thinking of the immediate consequences.

Each respondent’s knowledge of Type 2 diabetes was assessed through a series of thirteen questions. On average, participants answered correctly 63% of those questions on diabetes knowledge. The knowledge section of the questionnaire identified two gaps. The first is respondents had mainly incorrect perceptions or did not know that Type 2 diabetes is an illness in which one has more than normal levels of sugar in the blood. Second, about half – 49% – of respondents either answered incorrectly or “neither agree nor disagree” to the statement “Type 2 diabetes is related to eating too many fats”, which is in fact true.

Levels of knowledge about Type 2 diabetes among the general population vary with income, age, and ethnicity. Respondents to our questionnaire with an income of NZ$45,000 and under knew significantly less about Type 2 diabetes than people with an income over NZ$45,000. Participants forty years old and under knew less than those forty-one and over. Māori respondents knew significantly less than NZ European/Pakeha respondents.

From interviews with staff of a variety of organizations with health awareness missions similar to that of the Type 2 Diabetes Network, we learned that both positive and negative framing could be successful when creating campaign messages. Positive framing is best where support, encouragement, and motivation are desired. Negative framing can be used to initiate feelings of guilt or sadness that can ultimately prompt a change in behavior.

Combining findings from the questionnaire and from our expert interviews, we determined that television is the most effective channel of outreach to spread a message. Responses to our questionnaire identified television as the most common channel for seeing or hearing a diabetes advertisement. Our expert interviews further supported utilizing television advertisements as well as encouraged radio advertisements, which work well to reach the Pacific population. Furthermore, our expert interviews suggested posters as another effective way to spread campaign messages.

The experts we interviewed recommended scheduling a campaign in the month of January, on Mondays, and during peak as well as off-peak hours as the best strategy. January is right after the holidays when people are making New Year’s resolutions, are more open to change, and there is a less crowded media environment compared to December. People are most willing to change their behavior on Mondays. Also, a campaign utilizing television should schedule messages during peak – 6:00PM to 9:00PM – hours as well as off-peak – daytime hours.

Based upon our interviews we learned that funding is an essential component for the distribution of health awareness campaigns and programs. Funding increases the quantity of messages and channels of outreach as well as the quality of advertisements. Organizations can collaborate by utilizing networks and connections with other organizations, companies, and people to strengthen their effects within the community through gaining funding, support, advice, and helping one another.

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We recommend that organizations seeking to prevent Type 2 diabetes and promote healthy lifestyle choices in New Zealand:

Collaborate and link with one another. Collaboration increases brainpower as well as funding, thereby increasing the likelihood of a successful campaign.

Build public trust. Organizations should make themselves known to the public in order to create a personal connection because people trust familiarity. In order to build public trust, organizations should get their names and faces in the community by making appearances at public festivals and events of all varieties.

Target Māori and Pacific people, people with an income under NZ$45,000, and people forty years old and under. These three groups know less about Type 2 diabetes, which puts them at a greater risk for developing Type 2 diabetes because they are less aware of how to prevent it. It is nearly impossible to reach the general population with a campaign, and it is necessary to prioritize the audience most at risk for Type 2 diabetes.

Simplify the message of their awareness campaigns. For a campaign to be successful it must convey a clear message that can be easily understood by the target audience. An organization must take into account the baseline level of knowledge that the target audience already holds. The organization should choose a few key messages to convey to avoid overwhelming their target audience.

Develop advertisements applying the following guidelines. If resources are unlimited, a diabetes organization should: utilize both positively and negatively framed messages, to reach– both those who require support and those who require an extreme emotion to initiate change in behavior; frame the message around the long-term benefits of a healthy lifestyle as well as the consequences of Type 2 diabetes; utilize Māori and Pacific representatives as well as children in advertisements to be more relatable; utilize television and radio advertisements; and release advertisements in January, at peak and off-peak hours, on a Monday.

If resources are limited, a diabetes organization should follow the same guidelines as outlined above except for the following: utilize only positive framing and the long-term benefits of a healthy lifestyle, in addition to only posters as the channel of outreach.

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