Sweet Lies! Lessons Learned from Hawai'i's Sweetened Fruit Drink Countermarketing Campaign

Beverage industry marketing tactics can cause caregivers to misperceive sweetened fruit drinks (SFDs) as healthy, increasing the likelihood they give their children SFDs. The Sweet Lies! countermarketing campaign sought to educate Hawai'i caregivers of children ages 0-8 about the industry's misleading tactics and the harms of SFDs. Focus groups were held to develop messages for Hawai'i caregivers. The campaign ran January-April 2023 on television, digital and social media, radio, and in malls. Campaign effects were assessed with media metrics and pre-/post-campaign cross-sectional surveys. Pre-surveys were conducted November-December 2022 (n = 458) and post-surveys were conducted in May 2023 (n = 482) to evaluate campaign effects on caregivers' perceptions of SFD health risks and SFD purchases in a simulated store. Pre-/post-survey samples were demographically different precluding comparisons and post-survey data were unable to show differences in health risk ratings and SFD purchases by exposure. The campaign produced 32,155,747 impressions across media outlets. Post-survey data showed campaign recall of 36.9% and informed campaign revisions. Lessons learned, including the importance of formative research for campaign tailoring and evaluation for real-world campaign implementation, the value of panel surveys for rapid evaluations, and to plan for low exposure rates, are shared to inform other campaign and evaluation efforts.