Make a Healthy Splash: A Low-Cost, Multipronged Campaign to Improve Swimmer Behavior

Background:  In the U.S., swimming is the fourth most popular physical activity and the most popular among children. However, it can lead to diarrheal and other illnesses when germs are transmitted by ingesting, inhaling aerosols of, or having contact with contaminated water in swimming pools, hot tubs, and waterparks. A total of 215 swimming-related outbreaks affecting >15,000 people were reported to CDC for 2007–2010. Pool chemicals kill most germs—but some can survive for >10 days in properly treated water. Because swimmers themselves are the main source of water contamination, swimmer behavior plays a vital role in the transmission of germs.

Program background:  In May 2013, CDC executed a multipronged, yet unfunded (staff time only), national healthy swimming campaign to educate the public on what swimmers bring to the water and how to keep germs out. Campaign staff used a new laboratory study highlighting the presence of the fecal indicator E. coli in more than half of pool filter samples as a basis for crafting plain-language hygiene messages for the public. For example, we used “poop” instead of “feces.” The messages drove development of materials and activities with an on-the-go, media-savvy parent of young swimmers in mind: social and traditional media, a partnership with Olympic swimmer and mom Amanda Beard, web and print materials, and tools to help health departments and others disseminate localized messages.

Evaluation Methods and Results:  Measures of reach and engagement showed successful dissemination of healthy swimming messages to millions of people. Social media were effective in reaching a large audience and engaging the public, including a Twitter chat (reach: 26.6 million, adjusted reach: 2.8 million; 1,300 tweets, 600 contributors, and 4,500 click-throughs to CDC web materials) and additional social media messages, including a CDC Facebook post that was one of the most-shared in the past 2 years (964 shares, 410 likes, 180 comments). Traditional media outreach around the campaign led to 215 media stories (potential reach: 450 million; publicity value: $250,000)—the vast majority of which presented campaign messages clearly and accurately, if not verbatim. A partner-sponsored radio media tour cultivated nearly 900 placements (6 million impressions). Reach of new web content and a mobile application (6,000 views), listserv messages (41,000 recipients), and a toolkit for partners (47,000 recipients) was also measured.

Conclusions:  CDC’s healthy swimming campaign reinforced that health information is disseminated when messages are written clearly, in plain language that resonates with the public and media. This campaign not only demonstrates effective translation of scientific material, but also successful reach of and engagement with the target audience, swimmers and parents of young swimmers using social and traditional media and a number of other products centered on key behavior messages.

Implications for research and/or practice:  CDC’s healthy swimming campaign serves as a model for future low-cost campaigns that aim to disseminate health messages to a public audience. Lessons learned from its combination of social, electronic, and traditional media outreach will give communicators a foundation to adapt and tailor to different audiences and content areas.