J Commun Healthc

Background:Successful comprehensive population-based approaches to chronic disease prevention leverage mass media to amplify messages and support a culture of health. We report on a community-engaged formative evaluation to segment audiences and identify major themes to guide campaign message development for a transformative health communication campaign.Methods:Four key phases of campaign development: I) Formative evaluation to identify priorities, guiding themes, and audience segments (interviews/focus groups with residents, N=85; representatives of community-based partner organizations, N=10); II) Brand development (focus groups and closed-ended surveys; N=56); III) Message testing approaches to verbal and visual appeals (N=50 resident intercept interviews); IV) Workshop (N=26 participants representing 15 organizations).Results:Residents were engaged throughout campaign development and the resulting campaign materials, including the campaign name and visual aesthetic (logo, color schemes, overall look and feel) reflect the diversity of the community and were accepted and valued by diverse groups in the community. Campaign materials featuring photos of county residents were created in English, Spanish, and Hmong. Plain language messages on social determinants of health resonate with residents. The county was described as a sort of idyllic environment burdened by inequality and structural challenges. Residents demonstrated enthusiasm for the communication campaign and provided specific suggestions for content (education about disease risks, prevention, management; information about accessing resources; testimonials from similar people) and tone.Conclusions:Communication to support a policy, systems, and environmental change approach to chronic disease prevention must carefully match essential messages with appropriate audiences. We discuss challenges in such messaging and effectiveness across multiple, diverse audiences.K01 CA190659/CA/NCI NIH HHSUnited States/P30 DK092924/DK/NIDDK NIH HHSUnited States/U58 DP005710/DP/NCCDPHP CDC HHSUnited States