SKIP the Salt, Help the Heart

Overview and Challenge

High blood pressure, or hypertension, is often called the silent killer because people suffering from it may not notice any signs or symptoms. After tobacco, CDC Director Dr. Thomas Frieden has called it the second leading public health priority for intervention. While anyone can develop hypertension, some groups, such as African Americans, are at higher risk.

Aware that high blood pressure was an issue, state and local health planners approached the HCRC about launching a strategic communication campaign to raise awareness about the dangers of hypertension among African American populations living in six zip codes in Greater Kansas City.


Starting with our expertise in journalism, and health and science communication, the HCRC team developed a strategic communication research and implementation plan to guide our work on the ground. Working with local stakeholders from the beginning, the team reviewed the existing literature and survey instruments to develop a mixed-method approach to collect the necessary research to understand what people knew about high blood pressure, as well as their current health issues and behaviors.

In winter 2013, we launched a large telephone survey, held focus groups and conducted key informant interviews and tested many campaign concepts and messages.

Preliminary findings included:

  • Most African Americans in the sample knew that high salt diets could lead to chronic health disease and death;
  • Many did not find fear or negative messages about the risks of high salt diets compelling;
  • Some still had difficulty finding fresh fruits and vegetables to buy in a local market, and some also struggled with finding reliable transportation;
  • Many did not know that even fresh or frozen chicken could contain hidden salt;
  • Many thought that a low-sodium diet meant eating bland or tasteless foods.

Strategy and Creative Direction

One of the key findings from our research phase was that African Americans living in these areas knew the dangers of high salt consumption. However, they did not find messages that simply gave a behavior (for instance, “Eat less salt”) very compelling. Moreover, they did not report that messages appealing to a later benefit (“Eat less salt now and reduce your risk for heart attack later”) compelling either.

Instead, the HCRC examined the data to determine message opportunities, such as appealing to how people look and feel today. Similar to our framing work on Ozioma!, we crafted campaign messages to highlight an immediate benefit exchange (look good, feel good today). Then with a public health approach, the HCRC connected these messages to actual places where people could practice the behaviors. After reviewing evidence-based literature, the HCRC collaborated with two local corner stores in the Kansas City area to feature low-sodium items, as well as shelf-stable healthy items.

As these two corner stores rolled out their healthy items and “Health Shelves,” an overall SKIP brand and health communications campaign rolled out on local radio, public transportation, local newspapers, billboards and at community events.


The SKIP intervention in Kansas City resulted in over 13 million impressions from bus audio ads, billboards, newspaper, radio ads and community events. The pilot corner store intervention grew and one store developed a partnership with local urban farm initiatives, including Grown in Ivanhoe. A community leadership breakfast was held with local stakeholders to align efforts and lay the groundwork for sustainability. The HCRC’s creative work was also honored with a nomination for a national 2013 Mosaic award for its bus audio spots.

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