The findings show that the Good for Kids communication campaign effectively raised program awareness in the Hunter New England region. By the end of the program the brand, water, physical activity and vegetable campaigns were all effective and, after each campaign, parents in HNE were more likely than parents in NSW to identify the campaign messages that: children should drink water instead of sweetened drinks; be more active in play and sport, and cut down on small screen recreation and; eat more vegetables and fruit. There was also evidence that awareness of the program and campaigns reached all socio-demographic groups.
The awareness levels achieved in this study were similar to or higher than those achieved by other Australian government campaigns. For example, unprompted recall of the Get Moving campaign increased from 10% to 43%,  and recall of the NSW Go for 2 and 5 campaign increased from 46% to 68% . Prompted recall of the NSW Health water campaign in 2008 increased from 19% to 53% . It should be noted that the evaluation of this water campaign included parents from HNE where the same campaign had run earlier in the year and this may account for the higher NSW level of awareness at baseline (19%) compared to the level of awareness at baseline that was observed in the Hunter New England region (10%, see Figure 3). Evaluation of this campaign also found significant increases in parent’s awareness of the key messages, knowledge of the high sugar content of sweetened drinks (8% to 16%) and a decline in the reported consumption of sweetened drinks by boys and girls . Unlike Good for Kids, however, these campaigns were not sustained and were not supported by accompanying strategies, such as healthy eating and physical activity policy and programs in preschools, schools, sports clubs and community service agencies to facilitate to the adoption of the changes being promoted. Also, with regard to their evaluation, because they were run state-wide they did not have comparison data to determine background awareness and it is thus not possible to determine the effectiveness of these campaigns. Finally, we were able to show that all socio-demographic groups had increased awareness, demonstrating equity in the delivery of the program and campaigns.
Other programs targeting obesity have also used mass media to raise awareness, achieving similar or higher levels of awareness than observed in Good for Kids. The United States Centres for Disease Control used a multi-setting social marketing campaign called VERB to promote physical activity among youths (aged 9 to 13 years) nationally . Campaign awareness was 81% after two years of implementation. In 1998, the New South Wales government conducted a state-wide mass-media campaign to promote regular moderate-intensity physical activity among adults aged 25 to 60 who were motivated to increase their levels of physical activity but were insufficiently active . This campaign successfully increased unprompted and prompted recall of physical activity messages to 21% and 51% of the target population respectively.
To achieve high levels of community awareness, Hornik and Kelly emphasize the importance of obtaining high levels of exposure for messages . They note that paying for exposure is the only way of guaranteeing sufficient air time but that exposure can also be donated by media companies, for example through CSAs, and earned through editorial media coverage, or ‘making news’. Good for Kids earned editorial exposure through regular communication and building strong relationships with local media outlets, creating news through making program announcements, releasing research findings, holding community and media events and offering strong photo opportunities. Good for Kids program messages were also delivered via print media such as through newsletters and special publications distributed throughout the settings where program interventions were conducted (school newsletters, childcare centre websites etc.). The program also linked with parent’s networks and other relevant organisations to deliver program messages. For example, the Good for Kids vegetable campaign won the 2010 national Parents Jury (http://www.parentsjury.org.au) award for the best marketing campaign to promote healthy eating or physical activity to children. In addition, all program communication included an action point for the audience to visit the program website for further resources and information. The website http://www.goodforkids.nsw.gov.au played a crucial role as a platform for the many program audiences and stakeholders to interact with the program. The program website was also linked to and from other relevant stakeholder sites to gain further exposure for the program.
By using a mix of media (TV, radio, print, web and others) as well as donated (CSAs) and earned exposure (news releases and other contributions to local media outlets), Good for Kids partly overcame the limitation of having its television advertisements aired on only one station. Based on an independent assessment of the campaigns by Mediacom (a Sydney based media company) the target audience rating points (TARPS) for each of the campaigns achieved or exceeded (by 45-50%) what was planned for based on that anticipated by the media expenditure (data not shown). This meant that, due to CSAs, more of the target group of grocery buyers aged 25–54 years were exposed to the television advertisements than was paid for by the program. In accord with communication  and social marketing principles,  the Good for Kids program aimed to have a clearly defined target audience. Due to budget constraints that limited capacity to advertise the messages across a large number of segments, the program developed advertising that would appeal to target audience that included children and their parents. However, segmentation was facilitated within this audience using child and parent specific support materials (such as water bottles for kids and newsletters for parents) and some campaigns were directed more at kids (eg water campaign) or parents (eg vegetable campaign) depending on who was in the best position to act on the message. Formative research led to good message awareness by parents given the complexities associated with conveying simple and actionable diet and physical activity messages in an environment where people are exposed to competing messages from many sources [26, 27]. Also, it was useful to get target audience groups to reflect on previous campaigns to help improve subsequent campaigns. A challenge for Good for Kids, was timing the advertising campaigns so they coincided with the policy and program changes in preschool, schools and other settings. Ideally, for example, messages promoting fruit and vegetable consumption would have coincided with the launch of ‘Crunch and Sip’ , an initiative which provided time for children to eat fruit and vegetables in schools. However, the logistics of implementing multiple strategies in a variety of settings prevented such synergies occurring. Also, in line with communication principles, Good for Kids used a variety of media to deliver key messages.
There are several limitations that should be kept in mind when considering these findings. Firstly, the campaigns were not controlled over time (i.e. one campaign may have influenced awareness of another). This may explain the high baseline awareness of the water campaign in Hunter New England region (Figures 3 and 4). The water campaign began two weeks after the brand campaign, which included a prominent message about drinking water. Because these campaigns were close together, participants may have recalled the earlier campaign and message and hence inflated campaign awareness. Secondly, from survey five onwards, there may have been panel conditioning where participants responses were influenced by the number of times they had taken the survey. After three surveys over three years, panel conditioning was found to inflate the percentage of respondents in a cohort who reported awareness of the VERB campaign by about 8.5% . In our study, the overall sample and survey size meant each respondent was only likely to have been surveyed twice. Also, in all cases, differences in post-campaign awareness were greater than 10%. Thirdly, Good for Kids media and materials may have been seen in the comparison region, perhaps explaining the increase in program awareness among NSW participants (Figure 2). It is possible that news releases about the program contributed to this as ministerial releases about Good for Kids were regular and state-wide during the early years of the program. The 2008 NSW water campaign may also have increased comparison group awareness at survey 6 as this survey was conducted just as the campaign ended and the Good for Kids logo and tagline feature prominently in the water campaign advertisement. Additionally, the intervention and comparison areas shared a geographic boundary and there may have been some cross border contamination. Finally, the surveys had small sample sizes making small changes in program and campaign awareness difficult to detect. This also limited our ability to assess awareness among Aboriginal communities.