Testing a hierarchy-of-effects model
pathways from awareness to outcomes in the verb-tm campaign 2002-2003
Background: The McGuire hierarchy-of-effects (HOE) model, used extensively in mass-media interventions to describe the mechanisms for understanding effects, has not been tested in physical activity campaigns.
Design: Data collected at baseline (2002) and follow-up (2003) surveys in the VERB-tm evaluation were used in structural equation modeling to test pathways and hierarchies of campaign effects.
Conclusions: These findings provided limited support for the HOE model and suggest that increased awareness and understanding were the key proximal effects that led to behavior change. A distinct sequence of effects, which bypassed attitudes and outcome expectations, was found for these U.S. young people. The findings could inform the design of future campaigns to address youth physical activity.