<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article xmlns:xlink="http://www.w3.org/1999/xlink" xml:lang="en" article-type="research-article">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">101238455</journal-id>
<journal-title>International Journal of Environmental Research and Public Health</journal-title>
<issn pub-type="ppub">1661-7827</issn>
<issn pub-type="epub">1660-4601</issn>
<publisher>
<publisher-name>Molecular Diversity Preservation International (MDPI)</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3390/ijerph6122980</article-id>
<article-id pub-id-type="publisher-id">ijerph-06-02980</article-id>
<article-categories>
<subj-group>
<subject>Article</subject></subj-group></article-categories>
<title-group>
<article-title>“This Is Public Health: Recycling Counts!” Description of a Pilot Health Communications Campaign</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>L.Chase</surname><given-names>Nancy</given-names></name><xref ref-type="aff" rid="af1-ijerph-06-02980">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>Dominick</surname><given-names>Gregory M.</given-names></name><xref ref-type="aff" rid="af2-ijerph-06-02980">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>Trepal</surname><given-names>Amy</given-names></name><xref ref-type="aff" rid="af1-ijerph-06-02980">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>Bailey</surname><given-names>Leanne S.</given-names></name><xref ref-type="aff" rid="af3-ijerph-06-02980">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>Friedman</surname><given-names>Daniela B.</given-names></name><xref ref-type="aff" rid="af2-ijerph-06-02980">2</xref><xref ref-type="corresp" rid="c1-ijerph-06-02980">*</xref></contrib></contrib-group>
<aff id="af1-ijerph-06-02980">
<label>1</label> Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, South Carolina, 29208, USA; E-Mails: 
<email>CHASEN@mailbox.sc.edu</email> (N.L.C.); 
<email>ajtrepa@mailbox.sc.edu</email> (A.T.)</aff>
<aff id="af2-ijerph-06-02980">
<label>2</label> Department of Health Promotion, Education, and Behavior, University of South Carolina, 800 Sumter Street, Columbia, South Carolina, 29208, USA; E-Mail: 
<email>gdominick75@gmail.com</email></aff>
<aff id="af3-ijerph-06-02980">
<label>3</label> South Carolina Department of Health and Environmental Control, 2600 Bull Street, Columbia, South Carolina, 29201, USA; E-Mail: 
<email>baileyls@dhec.sc.gov</email></aff>
<author-notes>
<corresp id="c1-ijerph-06-02980">
<label>*</label> Author to whom correspondence should be addressed; E-Mail: 
<email>dbfriedman@sc.edu</email>; Tel: +1-803-777-9933; Fax: +1-803-777-6290.</corresp></author-notes>
<pub-date pub-type="ppub">
<month>12</month>
<year>2009</year></pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>11</month>
<year>2009</year></pub-date>
<volume>6</volume>
<issue>12</issue>
<fpage>2980</fpage>
<lpage>2991</lpage>
<history>
<date date-type="received">
<day>29</day>
<month>9</month>
<year>2009</year></date>
<date date-type="accepted">
<day>25</day>
<month>11</month>
<year>2009</year></date></history>
<permissions>
<copyright-statement>© 2009 by the authors; licensee Molecular Diversity Preservation International, Basel, Switzerland.</copyright-statement>
<copyright-year>2009</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0">
<p>This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).</p></license></permissions>
<abstract>
<p>This paper describes the development, implementation, and evaluation of a pilot recycling campaign. The goal of the campaign was to increase people’s awareness and knowledge about recycling and the link between a healthy environment and the public’s health. A total of 258 individuals attended campaign week events and completed an initial survey. Results identified inconvenience of recycling facility locations as a key barrier to recycling. Post-campaign survey results revealed increased recycling of paper, plastic, glass, and cans (p &lt; 0.05). The majority of participants “agreed” or “strongly agreed” that as a result of campaign messages they had greater awareness about recycling (88.4%) and their recycling efforts increased (61.6%).</p></abstract>
<kwd-group>
<kwd>recycling</kwd>
<kwd>environment</kwd>
<kwd>health communication</kwd>
<kwd>public health</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<label>1.</label>
<title>Introduction</title>
<sec>
<label>1.1.</label>
<title>Solid Waste Concerns in the United States</title>
<p>The United States (U.S.) is the number one trash-producing country in the world, creating 1,609 pounds per capita on an annual average [<xref ref-type="bibr" rid="b1-ijerph-06-02980">1</xref>]. Each day in the U.S., the average person generates more than four pounds of municipal solid waste. The majority of consumers report being opposed to pollution, but rarely identify with the fact that they themselves are significant contributors to it [<xref ref-type="bibr" rid="b2-ijerph-06-02980">2</xref>]. Although it is believed that 90% of this waste is recyclable, it is estimated that less than one third of it is currently recycled, with paper comprising a large proportion of municipal solid waste [<xref ref-type="bibr" rid="b3-ijerph-06-02980">3</xref>]. In addition, Americans use 2.5 million plastic bottles every hour, most of which are thrown away [<xref ref-type="bibr" rid="b1-ijerph-06-02980">1</xref>]. Treatment of solid wastes includes landfills, incineration with heat recovery, and composting [<xref ref-type="bibr" rid="b2-ijerph-06-02980">2</xref>]. According to the U.S. Environmental Protection Agency [<xref ref-type="bibr" rid="b4-ijerph-06-02980">4</xref>], 32.1% of solid waste is recycled, 13.6% is incinerated, and 54.3% ends up in landfills. The majority of damage done to the environment and peripheral ecosystems is directly related to human behavior. With a soaring population and overproduction of material goods, this solid waste will negatively impact our surrounding environment.</p></sec>
<sec>
<label>1.2.</label>
<title>Solid Waste Concerns in South Carolina</title>
<p>In 2008 in South Carolina, almost 13 million tons of solid wastes were created, and just under five million tons of solid wastes (38.5%) were recycled [<xref ref-type="bibr" rid="b5-ijerph-06-02980">5</xref>]. This number has decreased from a little over 8.5 million tons (50.2%) of recycled solid waste in 2007 [<xref ref-type="bibr" rid="b5-ijerph-06-02980">5</xref>]. Over 6.1 million tons of solid wastes were placed in landfills; 212,118 tons were placed in incinerators. The South Carolina state government developed yearly and long-term recycling goals. Unfortunately, the amount recycled in 2008 was only 24.0% of the set goal for that year [<xref ref-type="bibr" rid="b5-ijerph-06-02980">5</xref>].</p>
<p>By slightly modifying their actions, individuals can play a pivotal role in reducing the amount of garbage collected in their communities. Taking simple steps such as recycling plastic bottles and reusing empty cans and jars, shopping bags, and containers will help minimize unnecessary waste. According to the Department of Environmental Quality’s 2004 report, “throughout the United States, recycling has resulted in economic growth, income growth, net job increases, long-term investment, energy savings, waste reduction, lower production costs for many industries, and an extension of the life of landfills”. Furthermore, “only through a fundamental rethinking of our approach to waste can we preserve precious open space and protect our air, land, and water” [<xref ref-type="bibr" rid="b6-ijerph-06-02980">6</xref>].</p></sec>
<sec>
<label>1.3.</label>
<title>Previous Research on Community and University Recycling</title>
<p>Some research has been conducted to examine if increased recycling knowledge influences individuals’ and communities’ recycling behaviors. Community-based research found that residents’ awareness of each other’s recycling habits positively affected their recycling intentions [<xref ref-type="bibr" rid="b7-ijerph-06-02980">7</xref>]. Chan also found that social norms had an effect on recycling behaviors in a public housing complex [<xref ref-type="bibr" rid="b8-ijerph-06-02980">8</xref>]. In addition to friends, relatives, and neighbors, media outlets such as newspapers, television, and magazines, had an impact on community members’ recycling behaviors. A survey of Florida residents found that individuals living in areas with greater media exposure promoting recycling reported higher levels of recycling [<xref ref-type="bibr" rid="b9-ijerph-06-02980">9</xref>].</p>
<p>Studies on college campuses found that increased access to recycling bins coupled with raffles and contests led to improved recycling habits among students [<xref ref-type="bibr" rid="b10-ijerph-06-02980">10</xref>,<xref ref-type="bibr" rid="b11-ijerph-06-02980">11</xref>]. Another study that provided students with recycling bins for their rooms showed a reduction in the students’ waste stream and an increase in the percentage of waste that was recycled [<xref ref-type="bibr" rid="b12-ijerph-06-02980">12</xref>]. Other studies have assessed students’ attitudes toward recycling on campus. An older study by Williams [<xref ref-type="bibr" rid="b13-ijerph-06-02980">13</xref>] found that 68.4% of the students who read the daily paper would recycle it if there was a central place on campus to do so; 96.6% of the student respondents who lived on campus would recycle their daily paper if there was a drop-off bin on their residence hall floor. A more recent study by Kelly and colleagues [<xref ref-type="bibr" rid="b14-ijerph-06-02980">14</xref>] found that more individuals on campus said they would recycle if it was made more convenient and if they knew what happened to the recycled items after they were collected.</p>
<p>Limited environmental awareness and college campus culture are barriers to campus greening [<xref ref-type="bibr" rid="b15-ijerph-06-02980">15</xref>]. A survey conducted at Michigan State University found that university members believed recycling was important but they had limited knowledge regarding what they could recycle and places on campus where they could recycle [<xref ref-type="bibr" rid="b16-ijerph-06-02980">16</xref>]. This paper contributes to the current literature on recycling education and health communications campaign development, implementation, and evaluation. The goal of this South Carolina campaign was to increase people’s awareness and knowledge about recycling and about the link between a healthy environment and the public’s health.</p></sec></sec>
<sec sec-type="methods">
<label>2.</label>
<title>Methods</title>
<p>Nine graduate level applied health communications students and their faculty mentor (DBF) at the University of South Carolina secured a National Public Health Week grant to carry out the “This is Public Health” campaign funded by the Association of Schools of Public Health. Campaign activities were introduced to the University of South Carolina Columbia campus and the Greater Columbia, SC area during the April 2008 National Public Health Week. The study involved a pre/post-test evaluation of a university and community outreach program about recycling and healthy environments.</p>
<sec sec-type="subjects">
<label>2.1.</label>
<title>Research Sites and Participants</title>
<p>Since the University of South Carolina is a central part of the community, the campaign targeted both the university community and surrounding area. Campaign events took place at the South Carolina Public Health Association’s (SCPHA) annual Public Health Month kick-off event at the state museum, the university student union, and a local public library. There is a considerable amount of literature supporting the growing role of the library in providing consumers with public health information [<xref ref-type="bibr" rid="b17-ijerph-06-02980">17</xref>–<xref ref-type="bibr" rid="b19-ijerph-06-02980">19</xref>].</p></sec>
<sec>
<label>2.2.</label>
<title>Campaign Week Activities and Media Promotion</title>
<p>The University of South Carolina “This is Public Health” campaign team partnered with the SCPHA to participate in their annual Public Health Month Kick Off event which was held at the state museum. The campaign team held an information table where attendees were asked to complete the campaign survey. Each survey participant received a recycling bin and educational information about recycling. This event provided an excellent introduction to the campaign and an opportunity to integrate campaign activities into the community with a public health partner.</p>
<p>The local library is an active supporter of recycling, engaging in recycling activities on a daily basis, and promotional events such as recycling old phonebooks at the beginning of each year. As part of the campaign activities, the team set up information tables in the library’s activity room. In exchange for completing the campaign survey, participants received a reusable tote bag with educational information about recycling. The library also helped to promote the recycling campaign by advertising the campaign on the library’s webpage, in a local newspaper of community events, and in a school newsletter. A local news affiliate aired campaign activities at the library during National Public Health Week.</p>
<p>The university events were held at the student union building, a busy location frequently visited by on-campus and commuter students, staff, and faculty. Campaign activities took place during the busy meal hours. A campaign booth was set up and run by two to three members of the campaign team. Similar to the events at the library, individuals completing a survey received a reusable grocery bag that contained educational information about recycling. Campaign events taking place at the student union were promoted in the university student newspaper and on the campus radio station. One member of the campaign team also dressed as “Can Guy”, a member of the SC DHEC’s “Recycling Guys”.</p>
<p>Using the “This is Public Health” logo, the campaign team developed several promotional products. Two banners promoting the “This is Public Health: Recycling Counts!” message were created and displayed at all events and in the university’s public health building. Recyclable grocery bags with the logo were designed and distributed along with educational information about recycling. T-shirts were designed for the campaign team members to wear during the events so they were easily identifiable. The SCPHA and SC DHEC provided the campaign team with a multitude of educational resources. A brochure describing the importance of recycling and the link between health and recycling, a Public Health Week question and answer fact sheet, and county resource lists with recycling locations and materials accepted for recycling at various recycling depots were also distributed during the campaign week. Finally, participants were given bookmarks; mouse pads; pencils made of recycled jeans, money and paper; and coloring and activity books about recycling.</p>
<p>University-wide and local media was used to promote the campaign events. Two articles were posted on the university’s website, a letter to the editor was published in The State newspaper, and advertisements were run on the university’s daybook of events, cable network and telephone hold message. The campaign faculty mentor and one student also promoted the campaign in a radio interview on WGCV AM’s “Health, Wealth, and Happiness” program.</p></sec>
<sec sec-type="methods">
<label>2.3.</label>
<title>Data Collection: Self-Administered Surveys</title>
<p>A recycling survey consisting of ten Likert-type, multiple-choice, and fill-in-the-blank questions was developed to assess participants’ recycling behaviors, and information sources, knowledge, and attitudes about recycling and the environment. Pencil-paper surveys were administered during National Public Health Week at all campaign related activities, booths, and events (described in section 2.4). Survey questions were adapted from a SC Department of Health and Environmental Control (SC DHEC) Office of Solid Waste Reduction &amp; Recycling postcard survey and the Association of Schools of Public Health’s National Public Health Week sample list of questions e-mailed to “This is Public Health” grantees. A few additional questions were developed pertaining to recycling attitudes, knowledge, and behaviors. Survey questions were pilot tested with university students for clarity, word choice, and survey length.</p>
<p>Follow-up surveys were sent to participants three weeks after National Public Health Week campaign activities to determine if people’s awareness about recycling and recycling behaviors had changed as a result of the campaign. Participants’ pre/post surveys were matched using a numeric code. Once all completed post-surveys were received, participants were entered into a raffle. Individuals from the museum event were entered to win one of 10 reusable grocery bags, and participants from the student union and library were entered to win one of 15 gift cards.</p></sec>
<sec sec-type="methods">
<label>2.4.</label>
<title>Data Analysis</title>
<p>Survey results were analyzed in SPSS 16.0. Descriptive statistics (<italic>i.e.</italic>, frequencies) were generated. Chi-squares were used to examine survey results according to data collection site (university vs. community). Paired t-tests were used to determine differences in pre- and post-survey results for continuous variables (e.g., frequency of recycling pre-campaign vs. post-campaign). Statistical significance was set at <italic>P &lt; 0.05.</italic></p></sec>
<sec>
<label>2.5.</label>
<title>Campaign Framework</title>
<p>Development, implementation, and evaluation of the recycling campaign were based on Rudd and colleagues’ five-stage sustainability model (campaign design, promotion, demonstration, transfer of knowledge/skills, and sustainability) as shown in <xref ref-type="fig" rid="f1-ijerph-06-02980">Figure 1</xref> [<xref ref-type="bibr" rid="b20-ijerph-06-02980">20</xref>]. Principles of The Health Communication Unit’s <italic>Twelve Steps to Developing a Health Communication Campaign</italic> were also considered in campaign development and event promotion and organization [<xref ref-type="bibr" rid="b21-ijerph-06-02980">21</xref>].</p>
<p>When recycling was identified as the target behavior by the campaign team, “Recycling Counts!” was added to the “This Is Public Health” branding that had already been established by the funding agency. Existing promotional resources about recycling from reputable organizations (SCPHA and SC DHEC) were identified and featured heavily in campaign materials. Demonstration activities included the distribution of recycling bins and educational resources such as pamphlets specifying locations of recycling facilities to the campaign audience. Once the campaign ended, the recycling bins given to the audience and placed in the university setting would be used as a means to sustain recycling behaviors.</p></sec></sec>
<sec sec-type="results">
<label>3.</label>
<title>Results</title>
<sec sec-type="results">
<label>3.1.</label>
<title>Participation Results</title>
<p>The events and recycling efforts were well received by participants at all three campaign locations (museum, library, student union). To determine recycling habits of individuals at the university and in the Columbia, SC community, a total of 258 individuals were surveyed during campaign week: 147 at the university and 111 in the community. Fifty participants completed surveys at the museum campaign kick-off events, 61 at the library, and 147 at the university student union. The public library reached a diverse audience such as families with home-schooled children, military families, senior citizens, and children congregating for after school programming. Campaign promotion at the student union attracted the most students, faculty, and staff during lunchtime hours (11 am–1 pm).</p></sec>
<sec sec-type="methods|results">
<label>3.2.</label>
<title>Campaign Survey Findings</title>
<p>The initial campaign week survey results revealed that 114 of the 147 university participants (77.6%) recycled plastic most often followed by paper (76.2%) and glass (59.2%). Community participants reported recycling aluminum and tin cans most often (84.7%) followed by plastic (78.4%), and paper (73.0%) items (<xref ref-type="table" rid="t1-ijerph-06-02980">Table 1</xref>). The majority of participants from the university (53.7%) “agreed” that they made a conscious effort to recycle; fewer people “strongly agreed” (32.7%) or “disagreed” (8.8%) with this statement. Most community participants (54.1%) “strongly agreed” that they made a conscious effort to recycle; fewer “agreed” (39.6%); very few “disagreed” (3.6%). Few participants at the university (39/147 or 26.5%) and in the community (40/111 or 36.0%) stated that they were “very familiar” with their recycling schedule and guidelines. Overall, 36.4% (n = 94) of all participants were “somewhat familiar” or “unfamiliar” with guidelines.</p>
<p>The most commonly reported barrier to recycling in both the community (9.9%) and on campus (16.3%) was inconvenience regarding location of recycling facilities. A significantly greater percentage of university than community participants (15.6% vs. 7.2%) reported not having a recycling bin / limited access to bins as a key barrier to recycling (p = 0.039). Although selected less often, other barriers included time (University: 3.4%; Community: 1.8%), not knowing the recycling day (University: 5.4%; Community: 1.8%), not knowing which items to recycle (University: 3.4%; Community: 3.6%), and not caring (University: 3.4%; Community: 1.8%).</p>
<p>When asked from which media sources they heard / read about recycling and the environment, most people selected television and newspapers (<xref ref-type="table" rid="t2-ijerph-06-02980">Table 2</xref>). A significantly greater percentage of university participants learned about the benefits of recycling from the Internet (p = 0.025).</p>
<p>Finally, quite a few participants at both the university (70.7%) and in the community (76.6%) “strongly agreed” that the environment has an effect on human health. In addition, 79 (53.7%) university and 75 (67.6%) community members “strongly agreed” that recycling was indeed related to public health.</p>
<p>Follow-up surveys were sent to participants three weeks following National Public Health Week (<italic>i.e.</italic>, campaign implementation week) to determine if their awareness about recycling and recycling behaviors had changed as a result of the campaign. Twenty-six individuals completed the follow-up survey. Paired t-tests showed significant increases in the number of times per month that individuals recycled paper, plastic, glass, and cans (<xref ref-type="table" rid="t3-ijerph-06-02980">Table 3</xref>). The majority of participants (88.4%) “agreed” or “strongly agreed” that they had greater awareness about the link between recycling and public health as a result of the campaign. Furthermore, many participants (61.6%) “agreed” or “strongly agreed” that their recycling efforts increased as a result of the information they received from the “This is Public Health: Recycling Counts!” campaign.</p></sec></sec>
<sec sec-type="discussion|conclusions">
<label>4.</label>
<title>Discussion and Conclusions</title>
<p>National attention has turned toward environmental sustainability. In 2009, the U.S. Congress passed the American Clean Energy and Security Act with a goal to reduce greenhouse gases by 17% by the year 2020 [<xref ref-type="bibr" rid="b22-ijerph-06-02980">22</xref>]. Recycling efforts can effectively reduce adverse health effects caused by environmentally hazardous materials. The recycling industry also benefits local revenue, and contributes to employment and business expansion [<xref ref-type="bibr" rid="b6-ijerph-06-02980">6</xref>]. The purpose of this pilot study was to implement a health communications campaign about recycling during National Public Health Week 2008. Campaign goals were to increase knowledge and awareness about recycling and increase positive attitudes toward recycling, with the hope of increasing recycling behaviors. The impact of the campaign was strengthened through effective engagement with community partners. Survey results identified inconvenience of recycling facility locations as a key barrier to recycling by both university and community participants.</p>
<sec>
<label>4.1.</label>
<title>Recycling Knowledge and Behavior</title>
<p>General recycling information and recycling surveys were distributed and collected at predetermined locations on the university campus and within the community at a museum and local library. While participants did engage in some recycling and they understood the importance of recycling, many had not taken the time to familiarize themselves with recycling schedules and guidelines. Thus, the value that participants place on recycling may not be sufficient to promote recycling behaviors. Results from Kaplowitz and colleagues’ research [<xref ref-type="bibr" rid="b16-ijerph-06-02980">16</xref>] were similar in that recycling was hindered by a lack of knowledge specifically among college students regarding university recycling policies and schedules. Although recycling programs have become more common at universities, there is a need to increase public awareness of recycling policies regarding materials that can be recycled [<xref ref-type="bibr" rid="b11-ijerph-06-02980">11</xref>].</p></sec>
<sec>
<label>4.2.</label>
<title>Sources of Recycling Information</title>
<p>Overall, university and community members reported that they obtained recycling information primarily from television and newspaper sources. The challenge for most health communications programs is to tailor health messages effectively and to use appropriate media sources in order to maximize target reach with minimal program cost [<xref ref-type="bibr" rid="b23-ijerph-06-02980">23</xref>]. Although television is a popular form of media, the cost to broadcast recycling messages (e.g., public service announcements) may not be practical for grassroots and unfunded projects. This study incorporated several types of free or low cost local and university media outlets (broadcast and print) to increase recycling awareness.</p></sec>
<sec>
<label>4.3.</label>
<title>Barriers to Recycling</title>
<p>Overall, survey results revealed that individuals from the university and the community are recycling. Cans, plastic, and paper are the main materials being recycled. However, a key barrier to recycling was that it was not convenient. This result is consistent with previous research [<xref ref-type="bibr" rid="b24-ijerph-06-02980">24</xref>]. More accessible and convenient recycling locations and greater distribution of free recycling bins will be required to increase recycling rates on campus and in the community [<xref ref-type="bibr" rid="b11-ijerph-06-02980">11</xref>].</p></sec>
<sec sec-type="methods">
<label>4.4.</label>
<title>Study Limitations</title>
<p>This study has limitations. First, funding only permitted implementation of a brief campaign, thus it is unlikely that this project had a significant long term impact on the target population’s recycling behaviors. Second, pre-testing campaign messages is important when developing any communication based project. In this campaign, however, the “This is Public Health” slogan was provided to the team by the funding agency. “Recycling Counts!” was added to the initial slogan to more effectively communicate the connection between recycling, the environment, and public health. Third, demographic variables other than campaign site visited (museum, library, or student union) were not collected, thus recycling knowledge and behavior by age, gender, race / ethnicity or role (e.g., staff versus student) could not be examined. Fourth, a very small sample of individuals completed the post-campaign survey (n = 26), and a longer-term, more rigorous evaluation was not conducted as a part of this pilot campaign project. Finally, an assessment specifically of the effectiveness of the media promotion of the campaign was not conducted. It is recommended that an assessment of media messages is conducted for a larger recycling campaign.</p></sec>
<sec sec-type="methods|discussion">
<label>4.5.</label>
<title>Study Strengths and Implications</title>
<p>Despite study limitations, the campaign received attention through university and local media and was strengthened considerably by collaborative partnerships with the university, community, media, and state government. Partnerships are extremely important in campaign development [<xref ref-type="bibr" rid="b21-ijerph-06-02980">21</xref>]. Another positive outcome from this pilot project was with regard to sustainability. An informal partnership was established between the campaign team and university facilities, resulting in greater recycling opportunities and placement of an increased number of recycling bins in a public health building on the university campus.</p>
<p>The amount of paper Americans throw away each year is equivalent to one billion trees [<xref ref-type="bibr" rid="b1-ijerph-06-02980">1</xref>]. If all of the newspapers in the U.S. were recycled, 250 million trees would be saved each year. Recycling programs can contribute to improved public health by reducing unnecessary waste which harms the environment and in turn, negatively impacts global health outcomes [<xref ref-type="bibr" rid="b25-ijerph-06-02980">25</xref>]. Recycling centers must be accessible to its citizens and more recycling bins need to be located in work places and other public areas. Future large-scale media and educational campaigns should inform and promote recycling to facilitate personal, community, and societal changes [<xref ref-type="bibr" rid="b26-ijerph-06-02980">26</xref>,<xref ref-type="bibr" rid="b27-ijerph-06-02980">27</xref>]. Findings from this pilot study suggest that a theoretically driven health communications campaign to improve recycling behaviors may be effective in both university and community settings.</p></sec></sec></body>
<back>
<ack>
<p>Funding for this project was provided by the Association of Schools of Public Health. We thank the entire health communications class for their work and dedication to this campaign. We are grateful for the support of our project partners: 
<list list-type="simple">
<list-item>
<p>South Carolina Department of Health and Environmental Control</p></list-item>
<list-item>
<p>South Carolina Public Health Association</p></list-item>
<list-item>
<p>South Carolina Public Health Consortium</p></list-item>
<list-item>
<p>Healthy Carolina (University of South Carolina)</p></list-item>
<list-item>
<p>Richland County Public Library, Southeast Branch</p></list-item></list></p></ack>
<ref-list>
<title>References</title>
<ref id="b1-ijerph-06-02980"><label>1.</label><citation citation-type="web"><collab>National Institutes of Health Environmental Management System</collab><source>The clock is ticking—waste less recycle more</source> Available online: <ext-link xlink:href="http://www.nems.nih.gov/outreach/factsheet_recycling.pdf" ext-link-type="uri">http://www.nems.nih.gov/outreach/factsheet_recycling.pdf</ext-link> (accessed April 6, 2008).</citation></ref>
<ref id="b2-ijerph-06-02980"><label>2.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hamer</surname><given-names>G</given-names></name></person-group><article-title>Solid waste treatment and disposal: effects on public health and environmental safety</article-title><source>Biotechnol. Adv</source><year>2003</year><volume>22</volume><fpage>71</fpage><lpage>79</lpage><pub-id pub-id-type="doi">10.1016/j.biotechadv.2003.08.007</pub-id><pub-id pub-id-type="pmid">14623044</pub-id></citation></ref>
<ref id="b3-ijerph-06-02980"><label>3.</label><citation citation-type="book"><person-group person-group-type="author"><name><surname>Donatelle</surname><given-names>RJ</given-names></name></person-group><source>Health: the Basics</source><edition>7th ed</edition><publisher-name>Benjamin Cummings Publisher</publisher-name><publisher-loc>Boston, MA, USA</publisher-loc><year>2007</year></citation></ref>
<ref id="b4-ijerph-06-02980"><label>4.</label><citation citation-type="web"><collab>United States Environmental Protection Agency</collab><source>Municipal solid waste in the United States</source>Available online: <ext-link xlink:href="http://www.epa.gov/epawaste/nonhaz/municipal/pubs/msw07-rpt.pdf" ext-link-type="uri">http://www.epa.gov/epawaste/nonhaz/municipal/pubs/msw07-rpt.pdf</ext-link> (accessed July 20, 2009).</citation></ref>
<ref id="b5-ijerph-06-02980"><label>5.</label><citation citation-type="web"><collab>South Carolina Department of Health and Environmental Control</collab><source>Waste reduction and recycling annual reports: Section 1</source>Available online: <ext-link xlink:href="http://www.scdhec.gov/environment/lwm/recycle/pubs/section1.pdf" ext-link-type="uri">http://www.scdhec.gov/environment/lwm/recycle/pubs/section1.pdf</ext-link> (accessed July 20, 2009).</citation></ref>
<ref id="b6-ijerph-06-02980"><label>6.</label><citation citation-type="other"><collab>National Resources Defense Council</collab><source>In defense of recycling</source><comment>Available online: <ext-link xlink:href="www.nrdc.org/cities/recycling/recyc/recypre.asp" ext-link-type="uri">www.nrdc.org/cities/recycling/recyc/recypre.asp</ext-link> (accessed February 8, 2008)</comment></citation></ref>
<ref id="b7-ijerph-06-02980"><label>7.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Barr</surname><given-names>S</given-names></name><name><surname>Ford</surname><given-names>NJ</given-names></name><name><surname>Gilg</surname><given-names>AW</given-names></name></person-group><article-title>Attitudes towards recycling household waste in Exeter, Devon: quantitative and qualitative approaches</article-title><source>Local Env</source><year>2003</year><volume>8</volume><fpage>407</fpage><lpage>421</lpage><pub-id pub-id-type="doi">10.1080/13549830306667</pub-id></citation></ref>
<ref id="b8-ijerph-06-02980"><label>8.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chan</surname><given-names>K</given-names></name></person-group><article-title>Mass communication and pro-environmental behaviour: waste recycling in Hong Kong</article-title><source>J. Environ Manage</source><year>1998</year><volume>52</volume><fpage>317</fpage><lpage>325</lpage><pub-id pub-id-type="doi">10.1006/jema.1998.0189</pub-id></citation></ref>
<ref id="b9-ijerph-06-02980"><label>9.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Martinez</surname><given-names>MD</given-names></name><name><surname>Scicchitano</surname><given-names>MJ</given-names></name></person-group><article-title>Who listens to trash talk? Education and public media effects on recycling behavior</article-title><source>Soc. Sci. Q</source><year>1998</year><volume>79</volume><fpage>287</fpage><lpage>300</lpage></citation></ref>
<ref id="b10-ijerph-06-02980"><label>10.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Geller</surname><given-names>ES</given-names></name><name><surname>Chaffee</surname><given-names>JL</given-names></name><name><surname>Ingram</surname><given-names>RE</given-names></name></person-group><article-title>Promoting paper recycling on a university campus</article-title><source>J. Environ. Syst</source><year>1975</year><volume>5</volume><fpage>39</fpage><lpage>57</lpage></citation></ref>
<ref id="b11-ijerph-06-02980"><label>11.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Luyben</surname><given-names>PD</given-names></name><name><surname>Cummings</surname><given-names>S</given-names></name></person-group><article-title>Motivating beverage container recycling on a college campus</article-title><source>J. Environ. Syst</source><year>1981</year><volume>11</volume><fpage>235</fpage><lpage>245</lpage></citation></ref>
<ref id="b12-ijerph-06-02980"><label>12.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Pike</surname><given-names>L</given-names></name><name><surname>Shannon</surname><given-names>T</given-names></name><name><surname>Lawrimore</surname><given-names>K</given-names></name><name><surname>McGee</surname><given-names>A</given-names></name><name><surname>Taylor</surname><given-names>M</given-names></name><name><surname>Lamoreaux</surname><given-names>G</given-names></name></person-group><article-title>Science education and sustainability initiatives</article-title><source>Int. J. Sust. Higher Educ</source><year>2003</year><volume>4</volume><fpage>218</fpage><lpage>229</lpage><pub-id pub-id-type="doi">10.1108/14676370310485410</pub-id></citation></ref>
<ref id="b13-ijerph-06-02980"><label>13.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Williams</surname><given-names>E</given-names></name></person-group><article-title>College students and recycling: their attitudes and behaviors</article-title><source>J. Coll. Stud. Dev</source><year>1991</year><volume>32</volume><fpage>86</fpage><lpage>88</lpage></citation></ref>
<ref id="b14-ijerph-06-02980"><label>14.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kelly</surname><given-names>TC</given-names></name><name><surname>Mason</surname><given-names>IG</given-names></name><name><surname>Leiss</surname><given-names>MW</given-names></name><name><surname>Ganesh</surname><given-names>S</given-names></name></person-group><article-title>University community responses to on-campus resource recycling</article-title><source>Recyc. Conserv. Resour</source><year>2006</year><volume>47</volume><fpage>42</fpage><lpage>55</lpage><pub-id pub-id-type="doi">10.1016/j.resconrec.2005.10.002</pub-id></citation></ref>
<ref id="b15-ijerph-06-02980"><label>15.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Dahle</surname><given-names>M</given-names></name><name><surname>Neumayer</surname><given-names>E</given-names></name></person-group><article-title>Overcoming barriers to campus greening</article-title><source>Int. J. Sust. Higher Educ</source><year>2001</year><volume>2</volume><fpage>139</fpage><lpage>160</lpage><pub-id pub-id-type="doi">10.1108/14676370110388363</pub-id></citation></ref>
<ref id="b16-ijerph-06-02980"><label>16.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kaplowitz</surname><given-names>MD</given-names></name></person-group><article-title>Garnering input for recycling communication strategies at a Big Ten University</article-title><source>Resour. Conserv. Recy</source><year>2009</year><volume>53</volume><fpage>612</fpage><lpage>623</lpage><pub-id pub-id-type="doi">10.1016/j.resconrec.2009.04.018</pub-id></citation></ref>
<ref id="b17-ijerph-06-02980"><label>17.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kouame</surname><given-names>G</given-names></name><name><surname>Harris</surname><given-names>M</given-names></name><name><surname>Murray</surname><given-names>S</given-names></name></person-group><article-title>Consumer health information from both sides of the reference desk</article-title><source>Libr. Trends</source><year>2005</year><volume>53</volume><fpage>464</fpage><lpage>479</lpage></citation></ref>
<ref id="b18-ijerph-06-02980"><label>18.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Linnan</surname><given-names>LA</given-names></name><name><surname>Wildemuth</surname><given-names>BM</given-names></name><name><surname>Gollop</surname><given-names>C</given-names></name><name><surname>Hull</surname><given-names>P</given-names></name><name><surname>Silbajoris</surname><given-names>C</given-names></name><name><surname>Monnig</surname><given-names>R</given-names></name></person-group><article-title>Public librarians as a resource for promoting health: results from the Health for Everyone in Libraries Project (HELP) librarian survey</article-title><source>Health Promot. Pract</source><year>2004</year><volume>5</volume><fpage>182</fpage><lpage>390</lpage><pub-id pub-id-type="pmid">15090172</pub-id></citation></ref>
<ref id="b19-ijerph-06-02980"><label>19.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wood</surname><given-names>FB</given-names></name><name><surname>Lyon</surname><given-names>B</given-names></name><name><surname>Schell</surname><given-names>MB</given-names></name><name><surname>Kitendaugh</surname><given-names>P</given-names></name><name><surname>Cid</surname><given-names>VH</given-names></name><name><surname>Siegel</surname><given-names>ER</given-names></name></person-group><article-title>Public library consumer health information pilot project: results of a National Library of Medicine evaluation</article-title><source>Bull. Med. Libr. Assoc</source><year>2000</year><volume>88</volume><fpage>314</fpage><lpage>322</lpage><pub-id pub-id-type="pmid">11055298</pub-id></citation></ref>
<ref id="b20-ijerph-06-02980"><label>20.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rudd</surname><given-names>RE</given-names></name><name><surname>Goldberg</surname><given-names>J</given-names></name><name><surname>Dietz</surname><given-names>W</given-names></name></person-group><article-title>A five-stage model for sustaining a community campaign</article-title><source>J. Health Commun</source><year>1999</year><volume>4</volume><fpage>37</fpage><lpage>48</lpage><pub-id pub-id-type="doi">10.1080/108107399127084</pub-id><pub-id pub-id-type="pmid">10977277</pub-id></citation></ref>
<ref id="b21-ijerph-06-02980"><label>21.</label><citation citation-type="web"><collab>Health Communication Unit</collab><source>The [THCU]. Health communication campaigns in 12 steps</source>Available online: <ext-link xlink:href="http://www.thcu.ca/infoandresources/12stepshealth_communication.htm" ext-link-type="uri">http://www.thcu.ca/infoandresources/12stepshealth_communication.htm</ext-link> (accessed May 1, 2008).</citation></ref>
<ref id="b22-ijerph-06-02980"><label>22.</label><citation citation-type="web"><collab>U.S. House of Representatives</collab><source>Committee on Energy and Commerce. American Clean Energy and Security Act of 2009</source>Available online: <ext-link xlink:href="http://energycommerce.house.gov/index.php?option=com_content&amp;task=view&amp;id=1560" ext-link-type="uri">http://energycommerce.house.gov/index.php?option=com_content&amp;task=view&amp;id=1560</ext-link> (accessed July 10, 2009).</citation></ref>
<ref id="b23-ijerph-06-02980"><label>23.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Randolph</surname><given-names>W</given-names></name><name><surname>Viswanath</surname><given-names>K</given-names></name></person-group><article-title>Lessons learned from public health mass media campaigns: marketing health in a crowded media world</article-title><source>Annu. Rev. Public Health</source><year>2004</year><volume>25</volume><fpage>419</fpage><lpage>437</lpage><pub-id pub-id-type="doi">10.1146/annurev.publhealth.25.101802.123046</pub-id><pub-id pub-id-type="pmid">15015928</pub-id></citation></ref>
<ref id="b24-ijerph-06-02980"><label>24.</label><citation citation-type="web"><person-group person-group-type="author"><name><surname>Carmody</surname><given-names>AK</given-names></name></person-group><source>Barriers to recycling for Washington and Lee students</source>Available online: <ext-link xlink:href="http://environmentalstudies.wlu.edu/ENV295/carmody.pdf" ext-link-type="uri">http://environmentalstudies.wlu.edu/ENV295/carmody.pdf</ext-link> (accessed May 8, 2008).</citation></ref>
<ref id="b25-ijerph-06-02980"><label>25.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Platt</surname><given-names>B</given-names></name><name><surname>Seldman</surname><given-names>N</given-names></name></person-group><article-title>Recycling on the rise, but trash rising faster</article-title><source>From the Ground Up</source><year>2000</year><volume>32</volume><fpage>11</fpage><lpage>14</lpage></citation></ref>
<ref id="b26-ijerph-06-02980"><label>26.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tonglet</surname><given-names>M</given-names></name><name><surname>Phillips</surname><given-names>PS</given-names></name><name><surname>Read</surname><given-names>AD</given-names></name></person-group><article-title>Using the Theory of Planned Behavior to investigate the determinants of recycling behavior: a case study from Brixworth, UK</article-title><source>Resour. Conserv. Recy</source><year>2004</year><volume>41</volume><fpage>191</fpage><lpage>214</lpage><pub-id pub-id-type="doi">10.1016/j.resconrec.2003.11.001</pub-id></citation></ref>
<ref id="b27-ijerph-06-02980"><label>27.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hopper</surname><given-names>JR</given-names></name><name><surname>Nielsen</surname><given-names>JMC</given-names></name></person-group><article-title>Recycling as altruistic behavior: normative and behavioral <italic>strategies</italic> to expand participation in a community recycling program</article-title><source>Environ. Behav</source><year>1991</year><volume>23</volume><fpage>195</fpage><lpage>220</lpage><pub-id pub-id-type="doi">10.1177/0013916591232004</pub-id></citation></ref></ref-list>
<sec sec-type="display-objects">
<title>Figure and Tables</title>
<fig id="f1-ijerph-06-02980" position="float">
<label>Figure 1.</label>
<caption>
<p>“This is Public Health” Health Communications Campaign Model. *</p>
<p>* Adapted from [<xref ref-type="bibr" rid="b20-ijerph-06-02980">20</xref>].</p></caption><graphic xlink:href="ijerph-06-02980f1.gif"/></fig>
<table-wrap id="t1-ijerph-06-02980" position="float">
<label>Table 1.</label>
<caption>
<p>Types of material recycled, results from initial campaign week survey (N = 258).</p></caption>
<table frame="box" rules="cols">
<thead>
<tr>
<th valign="middle" align="left" rowspan="3"><bold>Material</bold></th>
<th valign="middle" align="left"><bold>University (N = 147)</bold></th>
<th valign="middle" align="left"><bold>Community (N = 111)</bold></th></tr>
<tr>
<th colspan="2" valign="bottom"><hr/></th></tr>
<tr>
<th valign="middle" align="left">No. (% of 147 total)</th>
<th valign="middle" align="left">No. (% of 111 total)</th></tr></thead>
<tbody>
<tr>
<td colspan="3" valign="bottom"><hr/></td></tr>
<tr>
<td valign="middle" align="left">Glass</td>
<td valign="middle" align="left">87 (59.2)</td>
<td valign="middle" align="left">54 (48.6)</td></tr>
<tr>
<td valign="middle" align="left">Plastic</td>
<td valign="middle" align="left">114 (77.6)</td>
<td valign="middle" align="left">87 (78.4)</td></tr>
<tr>
<td valign="middle" align="left">Paper</td>
<td valign="middle" align="left">112 (76.2)</td>
<td valign="middle" align="left">81 (73.0)</td></tr>
<tr>
<td valign="middle" align="left">Cardboard</td>
<td valign="middle" align="left">61 (41.5)</td>
<td valign="middle" align="left">51 (45.9)</td></tr>
<tr>
<td valign="middle" align="left">Batteries</td>
<td valign="middle" align="left">32 (21.8)</td>
<td valign="middle" align="left">30 (27.0)</td></tr>
<tr>
<td valign="middle" align="left">Cans</td>
<td valign="middle" align="left">111 (75.5)</td>
<td valign="middle" align="left">94 (84.7)</td></tr>
<tr>
<td valign="middle" align="left">Compost</td>
<td valign="middle" align="left">17 (11.6)</td>
<td valign="middle" align="left">26 (23.4)</td></tr></tbody></table></table-wrap>
<table-wrap id="t2-ijerph-06-02980" position="float">
<label>Table 2.</label>
<caption>
<p>Media sources consulted for recycling information, results from initial campaign week survey (N = 258).</p></caption>
<table frame="box" rules="cols">
<thead>
<tr>
<th valign="middle" align="left" rowspan="3"><bold>Recycling information source</bold></th>
<th valign="middle" align="left"><bold>University (N = 147)</bold></th>
<th valign="middle" align="left"><bold>Community (N = 111)</bold></th></tr>
<tr>
<th colspan="2" valign="bottom"><hr/></th></tr>
<tr>
<th valign="middle" align="left">No. (% of 147 total)</th>
<th valign="middle" align="left">No. (% of 111 total)</th></tr></thead>
<tbody>
<tr>
<td colspan="3" valign="bottom"><hr/></td></tr>
<tr>
<td valign="middle" align="left">Television</td>
<td valign="middle" align="left">120 (81.6)</td>
<td valign="middle" align="left">91 (82.0)</td></tr>
<tr>
<td valign="middle" align="left">Newspaper</td>
<td valign="middle" align="left">90 (61.2)</td>
<td valign="middle" align="left">59 (53.2)</td></tr>
<tr>
<td valign="middle" align="left">Radio</td>
<td valign="middle" align="left">54 (36.7)</td>
<td valign="middle" align="left">47 (42.3)</td></tr>
<tr>
<td valign="middle" align="left">Internet</td>
<td valign="middle" align="left">83 (56.5)</td>
<td valign="middle" align="left">47 (42.3)</td></tr>
<tr>
<td valign="middle" align="left">Magazine</td>
<td valign="middle" align="left">55 (37.4)</td>
<td valign="middle" align="left">43 (38.7)</td></tr>
<tr>
<td valign="middle" align="left">No information received</td>
<td valign="middle" align="left">9 (6.1)</td>
<td valign="middle" align="left">13 (11.7)</td></tr></tbody></table></table-wrap>
<table-wrap id="t3-ijerph-06-02980" position="float">
<label>Table 3.</label>
<caption>
<p>Average number of times participants recycled per month: a pre/post campaign comparison (N = 26).</p></caption>
<table frame="box" rules="cols">
<thead>
<tr>
<th valign="middle" align="left" rowspan="3"><bold>Item</bold></th>
<th valign="middle" align="center" colspan="2"><bold>Mean (SD)</bold></th>
<th valign="middle" align="center"><bold>Significance Level</bold></th></tr>
<tr>
<th colspan="3" valign="bottom"><hr/></th></tr>
<tr>
<th valign="middle" align="center"><bold><italic>Pre-Campaign</italic></bold></th>
<th valign="middle" align="center"><bold><italic>Post-Campaign</italic></bold></th>
<th valign="middle" align="center"><bold><italic>P-values</italic></bold></th></tr></thead>
<tbody>
<tr>
<td colspan="4" valign="bottom"><hr/></td></tr>
<tr>
<td valign="middle" align="left"><bold>Paper</bold></td>
<td valign="middle" align="center">8.46 (10.19)</td>
<td valign="middle" align="center">12.00 (15.78)</td>
<td valign="middle" align="center">P = 0.026</td></tr>
<tr>
<td valign="middle" align="left"><bold>Plastic</bold></td>
<td valign="middle" align="center">7.13 (8.66)</td>
<td valign="middle" align="center">11.50 (13.26)</td>
<td valign="middle" align="center">P = 0.018</td></tr>
<tr>
<td valign="middle" align="left"><bold>Glass</bold></td>
<td valign="middle" align="center">5.17 (7.01)</td>
<td valign="middle" align="center">5.83 (9.51)</td>
<td valign="middle" align="center">P = 0.032</td></tr>
<tr>
<td valign="middle" align="left"><bold>Cans</bold></td>
<td valign="middle" align="center">6.96 (8.76)</td>
<td valign="middle" align="center">9.96 (11.94)</td>
<td valign="middle" align="center">P = 0.023</td></tr></tbody></table></table-wrap></sec></back></article>
