Community-based Infant Mortality Prevention/Reduction Projects

Summary Report

OKLAHOMA STATE DEPAR TMENT OF HEALTH/MATE RNAL AND CHILD HEALT H SERVICE

December 31, 2013 Community-based Infant Mortality Prevention/Reduction Projects Summary Report

Background

Infant mortality is the death of a baby before its first birthday. The infant mortality rate (IMR) is defined as the number of infant deaths per 1000 live births. Although Oklahoma has seen a decline in the IMR since 2007 from 8.6 to 7.7 in 2012, there is still much to accomplish. On average in Oklahoma, approximately 400 infants die each year. Further, African American and Native American babies die at higher rates than White babies.

The top three rankable causes of infant death in Oklahoma are:

• Congenital malformations (medical condition present at birth) • Disorders related to short gestation (less than 37 weeks of completed pregnancy) and low birth weight (less than five pounds eight ounces) • Sudden Infant Death Syndrome (SIDS)

A number of factors are associated with infant mortality such as maternal health, access to and quality of medical care, socioeconomic conditions, and public health practices. The Oklahoma State Department of Health (OSDH), along with many partners, is working to address these factors through the Preparing for a Lifetime, It’s Everyone’s Responsibility initiative. Multiple strategies are implemented through this statewide initiative to reduce infant mortality in Oklahoma, including community-based projects.

Community-based Projects

To increase reach with critical messages regarding ways to address the top three causes of infant mortality in Oklahoma, the OSDH extended an invitation to county health departments throughout the state to submit a budget and work plan to address infant mortality in their communities. Reaching out to communities also served as a follow-up strategy from the Oklahoma Leadership Summit on Infant Mortality conducted in October 2012. At the Summit, key leaders from across the state convened to learn about infant mortality and commit to taking action toward improving birth outcomes in Oklahoma.

Community-based projects also provided opportunities to engage local partners in relevant activities and enhance the sustainability of the local work, with the overall intent of contributing to the reduction of infant mortality.

The Oklahoma legislature supported the efforts of the community-based projects through funding to enhance and strengthen the infrastructure as well as address the issues that

January 2014 contribute to the leading causes of infant death by focusing on preconception/interconception health and care, preterm birth, and infant safe sleep.

Implementation

An invitation was sent to County Health Department Regional Directors. Both rural and urban counties responded. Forty-eight of 77 counties, many of which have the highest infant mortality rates in the state, implemented community-based projects. A map identifying counties that implemented projects is presented below.

Community -based Infant Mortality Reduction Projects

Various activities were implemented by the community-based projects including local health events, such as community baby showers in which education and resources were provided to those who attended. Pregnant women, fathers, grandparents, adoptive parents, and care takers were among baby shower participants. A substantial minority population was reached through the baby showers held in both rural and urban areas across the state.

Other activities included conducting presentations at local festivals on issues related to infant mortality such as the negative impact of smoking during pregnancy and the benefits of a smoke-free environment for babies. Other topics included infant safe sleep, infant injury prevention, the importance of a full-term pregnancy, and being healthy before and between pregnancies by specifically promoting folic acid to help prevent birth defects.

Dissemination of educational materials was also a key activity. Materials developed by the Preparing for a Lifetime initiative, March of Dimes, and the Tobacco Settlement Endowment Trust (Oklahoma Tobacco Helpline) were among the informative resources distributed to thousands of individuals.

January 2014 Social media was utilized to disseminate relevant educational messages through Facebook, Twitter, and Pinterest. Text4baby, a free text messaging service that provides health-related text messages on topics such as nutrition, prenatal care, labor and delivery, immunizations, and breastfeeding, was also promoted. Many pregnant women enrolled in Text4baby during the community baby showers.

Local media campaigns were launched from March through September that included billboards, public service announcements on radio, television, and in movie theatres, as well as newspaper ads and inserts providing key messages and publicizing local baby showers. Multiple creative pieces were developed to meet specific needs of the community-based projects but will also be utilized for the overall Preparing for a Lifetime initiative. An inventory of products is available for use by local and state level partners. A report generated by VI Marketing and Branding (VI), the media contractor for the Preparing for a Lifetime initiative, is attached as Appendix A and provides details on local media campaigns. According to the report, local media campaigns coordinated by VI achieved an estimated 34,246,000 impressions. “Impressions” is defined as an estimate of the average audience that sees or hears the message.

Evaluation

Both process measures and short-term outcomes were noted regarding the community- based projects. Local activities were conducted that would not have been possible without the support provided at the state level. Populations were reached that would likely not have received the education and resources offered during community health events, in particular the community baby showers that were hosted in low-income rural areas. The magnitude of reach accomplished through the local media campaigns surpassed expectations. Millions of Oklahomans were exposed to messages geared toward preventing infant mortality.

Short-term outcomes included an increased understanding of issues related to infant mortality as reported by participants of local health events. Partnerships with local groups were initiated and/or strengthened regarding the planning and implementation of local activities. Some of the partners include faith-based organizations, medical professionals, tribal entities, education, media outlets, local businesses and more. We also learned that community efforts will contribute to the sustainability of messages and activities to prevent infant mortality. Many of the projects indicated that community baby showers will become annual events.

Some challenges were experienced through implementation of the projects. For example, some project coordinators communicated that the process was somewhat cumbersome because several entities were involved in the approval of activities. Also, no

January 2014 incentives were provided with the legislative funding. However, this proved to be a positive point as local partners demonstrated their support by providing incentive items for health fairs and baby showers. Media products were specifically tailored based upon local feedback. As a result, billboard language was shortened and clarified resulting in a more streamlined, effective message.

Successes noted as a result of the community projects are numerous. Communities experienced sizeable participation at community health events, including baby showers, which provided an opportunity to directly educate hundreds of individuals on issues related to infant mortality. Additionally, participants included populations and areas with high infant mortality rates and expanded beyond pregnant women to include fathers, grandparents, and others. When participants were asked on post-event surveys how they will use the information presented, some of the participant comments included, “be better prepared for my first born” (21-year-old female), “to take care of my baby” (18-year-old male), and “to take care of my grandbabies” (46-year-old female).

Future Steps

To help maintain the momentum initiated through the community-based projects, continued support will be provided in the form of technical assistance, educational resources, on-site presentations, and more. Infant Mortality Awareness Month will continue to be recognized through local activities each September. Products, e.g., public service announcements, will continue to be developed and an inventory of products will be maintained for use at the local level. Finally, regular contact will continue with local projects to learn about challenges and successes and approaches for continued support and success.

Conclusion

In order to impact Oklahoma’s infant mortality rate, multiple strategies must take place at multiple levels – both state and local. The community-based projects achieved successes beyond initial expectations. Communities enthusiastically committed to addressing infant mortality locally. Awareness of the issue was raised. Partners were engaged in and supportive of local efforts. The diversity of local partnership was expanded to include non-traditional partners. And sustainability of efforts, e.g., local media campaigns and baby showers, is enhanced. In summary, the community-based projects to prevent/reduce infant mortality proved to be a warranted investment in the health and well-being of Oklahoma’s babies and families.

January 2014 Appendix A

Community Media Plans Evaluation

January 2014

FHS-13-01 Community Media Plans Evaluation

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

OVERVIEW:

VI and OSDH worked together to provide Preparing for a Lifetime campaign materials to local community groups across the state of Oklahoma to promote infant mortality prevention messages from a local level. Through the collaboration of VI’s staff, OSDH and local community groups, we were able to generate millions of impressions of our messages in many areas of the state. The process started with each community group sending VI a detailed budget form. We used the information on the forms (including budget, desired target and existing media relationships) to create a recommended media plan for each community. We scheduled conference calls with each community’s project coordinator to review and explain their media plans and make any necessary changes. VI booked the media on behalf of the community groups, and the media outlets billed each community directly. Only VI’s time spent media planning, working with coordinators, preparing creative and disseminating final creative to media outlets was billed to OSDH. VI billed for all account coordination and creative, but the community paid for production and ad placements directly. After plans were approved, we worked with the project coordinators to customize our existing art to meet their needs. The coordinators chose from a catalog of print, outdoor, theater and radio creative pieces and could customize them with their health department logos, coalition names, or community baby shower event information. Once artwork was created, approved by the community coordinator and sent through VI’s formal proofing process, the ads were distributed to the media vendors to run as booked on the plan. The following information is an overview of the plans, creative and impressions that VI helped execute for each community that we worked with through the entire process. Some communities opted to book their own media, decided not to approve their media plan, or for any other reason decided not to participate. Those communities are not included in this evaluation. It is important to note that all of the following information is based off of the media plan that VI booked. Any changes that happened after booking were not accounted for in this document because we did not receive the final itemized media invoices.

A glossary of the media terms used in this report is provided at the end of the document.

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

CREATIVE PIECES:

Generic Print Preconception Print Safe Sleep Print

Preterm Birth Print Tobacco Cessation Print

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Adair, Muskogee, Sequoyah, and Wagoner 1 | MEDIA PLAN

p BUDGET: $8,055 p The local county health department indicated they wanted to use radio, TV and outdoor for their plan. p RADIO: Radio was purchased on KTFX station at 30 spots per week for three consecutive weeks. KTFX ran a matching bonus schedule as added value, which means for every one paid spot, they ran one spot at no cost. p TV: We purchased Muskogee Cable at about 140 paid spots per week with a matching bonus schedule on channels popular with young women for a total of 280 spots. p OUTDOOR: Four outdoor boards were placed in Sequoyah and Adair counties. Each board was negotiated based on a two-month contract. Both outdoor companies left our creative up beyond the end of the contract for an additional three weeks at no cost as added value.

2 | CREATIVE

p RADIO: An even mix of Safe Sleep and Preconception 30-second radio spots were played on the station at various times throughout a three-week period from May 6 to 26. p TV: Preconception and Keep Cool P4L PSAs ran on Muskogee Cable about 200 times per week between May 6 and June 2. p OUTDOOR: Two Safe Sleep outdoor boards and two Preconception outdoor boards were displayed from May 13 to July 28.

3 | IMPRESSIONS

p ACTUAL NET COST OF PLAN: $7,906.75 p Total Net for Media: $6,476.75

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

p Total Net for Production: $1,430.00 p More than 1,382,500 impressions were delivered across all media over the duration of the plan. Impressions are estimated based on the media as it was booked. - Radio station KTFX-FM is a country station that reaches three of the four counties on this plan: Muskogee, Sequoyah and Wagoner. We estimate a total of 23,600 impressions were delivered over the three-week flight to our target of Women 18-49, women who are or may become pregnant, and/or young mothers. - Cable was purchased for Muskogee County. Four networks that over-index with our target, meaning that the networks had better ratings than the average with our target, were purchased: ABC Family, BET, Discovery and Lifetime. We estimate a total of 71,150 impressions were delivered over the four-week flight. - Four outdoor locations were also included on this plan. The impressions delivered by each location are as follows: Muskogee County: 27,256 impressions per week (x11 weeks) Sequoyah County: Sallisaw: 37,319 impressions per week (x11 weeks) Muldrow: 23,500 impressions per week (x11 weeks) Adair County: 29,000 impressions per week (x11 weeks)

confidential October 2013

Oklahoma State Department of Health FHS-13-01 Adair, Muskogee, Sequoyah, Wagoner County Community Plans Prepared by VI Marketing and Branding - Confidential - May 16, 2013 - ACTUALS Circulation/ May June July Average Total NET Total Subscribers/ Frequency Cost/CPP Cost Billing Medium Traffic 29 6 13 20 27 3 10 17 24 1 8 15 22 Demo: pregnant women/young mothers

RADIO (:30, M-F 6a-7p) KTFX-FM (101.7/Country) 12,000 45 $19.00 $855.00 $726.75

CABLE (:30, avg. 100x/wk.) Muskogee Cable 11,292 200 $15.00 $3,000.00 $2,550.00

OUT OF HOME Muskogee County N Main St. 0.4 mi s/o Shawnee Bypass (Muskogee Lamar) 27,256 2 $529.41 $1,058.82 $900.00 Sequoyah County I-40 0.1 mi. W/O Hwy 59 NSWF (Sallisaw area Lamar) 37,319 2 $735.29 $1,470.58 $1,249.99 Hwy 64 in Muldrow, across from football field (Bailey's) 4,700 2 $323.53 $647.06 $550.00 Adair County Hwy 59 N at Westville (Bailey's) 5,800 2 $294.12 $588.24 $500.00 Total cost based on planning rates and is subject to change. Matching bonus will be negotiated upon booking cable and out of home. Cable Radio Total $7,619.70 Lamar production total $730. Outdoor Bonus Outdoor PENDING Less 15% $6,476.75 Bailey production total $700. Total Media $6,476.75 Total Production $1,430 Total Cost $7,906.75

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Beckham, Greer, Harmon, Jackson, Roger Mills, Tillman 1 | MEDIA PLAN

p BUDGET: $20,000 p RADIO: We booked 15-20 paid radio spots per week, per station with a matching one to one bonus schedule on five local radio stations: KEYB, KWHW, KTIJ, KECO KQTZ for a total of 1,200 spots. This community group also got some extra coverage from P4L radio spots on Comanche and Custer county radio stations. p PRINT: Sixteen half-page, full-color print ads ran in seven local newspapers: Altus Times, Frederick Press Leader, Daily Elk Citian, Elk City Daily News, Sayre Record, Hollis News and Mangum Star News. p CABLE: Two cable systems were purchased: Cable One North and Cable One South. One hundred paid spots were booked per week on each system, utilizing networks that perform well with the target such as Lifetime, TVLand, USA and TNT. Each cable system also ran a matching bonus schedule with the paid schedule resulting in a total of 800 spots per system over the four-week flight. p OUTDOOR: Four outdoor boards were booked for two months each with an extra month of time, free of charge.

2 | CREATIVE

p RADIO: The Preterm Birth radio spot ran on all five stations tagged with the name of the county health department where the ad was broadcast. p PRINT: The Preterm Birth and Safe Sleep ads ran in each of the newspapers tagged with its corresponding county health department logo. p CABLE: Safe Sleep and Preterm Birth P4L PSAs ran on two cable networks for four weeks at about 100 paid spots per week. p OUTDOOR: Three Preterm Birth and one Safe Sleep outdoor board were installed in three towns and remained up from May through the end of July.

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

3 | IMPRESSIONS

p ACTUAL NET COST OF PLAN: $20,729.13 p Total Net for Media: $19,569.13 p Total Net for Production: $1,160.00 p More than 4,498,000 impressions were delivered across all media over the duration of the flight. Impressions are estimated based on the media as it was booked. - Print media purchased earned a total of 40,148 impressions over the course of the plan. The breakout for impressions earned per newspaper are outlined below: Altus Times: 23,408 impressions Frederick Press Leader: 2,514 impressions Daily Elk Citian: 6,894 impressions Hollis News: 3,516 impressions Mangum Star: 4,566 impressions - Five radio stations were purchased on this plan and earned a total of 3,585,100 impressions over the seven-week flight. Impressions earned per station is below: KEYB-FM: 977,500 impressions KWHW-FM: 256,000 impressions KTIJ-FM: 170,700 impressions KECO-FM: 1,801,600 impressions KQTZ-FM: 379,300 impressions - Two cable systems were booked for a four-week flight. Combined, the systems earned 34,100 impressions. - Four outdoor boards were purchased on this plan and earned more than 830,000 impressions for the entire 13-week flight. The breakout per board is outlined below: Altus US Hwy 62: 22,500 impressions per week (x13 weeks) Altus US Hwy: 25,000 impressions per week (x13 weeks) Mangum: 9,000 impressions per week (x13 weeks) Frederick: 7,500 impressions per week (x13 weeks)

confidential October 2013

Oklahoma State Department of Health FHS-13-01 Beckham/Greer/Harmon/Jackson/Roger Mills/Tillman County Community Plans Prepared by VI Marketing and Branding - Confidential - May 21, 2013 - ACTUALS Circulation/ May June July Average NET Total Subscribers/ Frequency Total Cost Cost/CPP Billing Medium Traffic 29 6 13 20 27 3 10 17 24 1 8 15 2 Demo: pregnant women/young mothers PRINT (1/4 pg, color) Altus Times (Sun-black/white) 3,901 4 $459.53 $1,838.12 $1,562.40 Frederick Press Leader (Wed-black/white) 838 2 $292.76 $585.52 $497.70 Daily Elk Citian (Sat) 2,298 2 $262.94 $525.88 $447.00 Elk City Daily (Sun) 3,272 2 $675.88 $1,351.76 $1,056.00 Sayre Record & Beckham County Democrat (Wed) 2,050 2 $335.29 $670.58 $570.00 Hollis News (Th) 1,172 2 $195.29 $390.58 $320.00 Mangum Star News (Th) 1,522 2 $174.68 $349.36 $286.96

RADIO (:30, M-F, 6a-7p) KEYB-FM (107.9/Country) 9,000 135 $9.00 $1,215.00 $1,032.75 KWHW (93.5/Country) 2,200 135 $9.41 $1,270.35 $1,079.80 KTIJ-FM (107.9/CHR) 6,100 110 $22.00 $2,420.00 $2,057.00 KECO-FM (94.3/Country) 7,200 110 $19.00 $2,090.00 $1,776.50 KQTZ-FM (Adult Hits) 1,300 110 $9.41 $1,035.10 $879.84 KWEY spill (Custer Co.) KLAW spill (Comanche Co.)

CABLE (:30) Cable One North 16,037 400 $8.24 $3,296.00 $2,801.60 Cable One South 12,443 400 $8.24 $3,296.00 $2,801.60

OUT OF HOME Altus US 62, 3.3 mi. e/o US 283, NSEF 4,500 2 $352.94 $705.88 $600.00 Altus US 283, S. edger of Blair, WSNF 5,000 2 $352.94 $705.88 $600.00 Mangum 1209 N Louis Tittle, WSSF 1,800 2 $352.94 $705.88 $600.00 Fredrerick US 183, 0.8 mi. s/o Hwy 5, WSNF 1,500 2 $352.94 $705.88 $600.00

Totals are based on planning rates and are subject to change. Out of home Print Bonus will be negotiated upon booking radio and out of home. Bonus Out of Home Radio Total $23,157.77 Production for outdoor boards is $1,160 and is not included in the total cost. Less 15% $19,569.13

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Blaine 1 | MEDIA PLAN

p BUDGET: $2,500 p OUTDOOR: One outdoor board was purchased in Watonga for a two-month period of time. The outdoor company agreed to leave the creative up for an additional two weeks at no charge as added value. 2 | CREATIVE

p OUTDOOR: The Preconception outdoor board was installed in Watonga with the tag “Brought to you by Blaine County Health Department.”

3 | IMPRESSIONS

p ACTUAL NET COST OF PLAN: $900.00 p Total Net of Media: $600.00 p Total Net of Production: $300.00 p More than 189,750 impressions were delivered over the duration of the 11-week flight. Impressions are estimated based on the media as it was booked. - The outdoor board booked in Watonga at Hwy 270 earned 17,250 impressions per week.

confidential October 2013

FHS-13-01 Blaine County Community Media Plans Prepared by VI Marketing and Branding - Confidential - May 17, 2013 - ACTUALS Circulation/ May June July Average NET Total Subscribers/ Frequency Total Cost Cost/CPP Billing Medium Traffic 29 6 13 20 27 3 10 17 24 1 8 15 22 Demo: pregnant women/young mothers

OUT OF HOME Watonga -Hwy 270 0.7 mi w/o Hwy 8 3,450 2 $352.94 $705.88 $600.00

Total based on plannng cost and is subject to change. Production for all outdoor is estimated at $300 Total $705.88 Less 15% $600.00

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Canadian, Custer, and Washita 1 | MEDIA PLAN

p BUDGET: $3,300 p PRINT: We booked four quarter-page, full-color print ads in two local newspapers: the Yukon Review and Mustang News. p RADIO: We booked four consecutive weeks of radio on KWEY at about 15 paid spots per week. KWEY provided a matching bonus schedule of one free spot for every paid spot. A total of 120 spots ran over the four-week flight. This community also had some radio spill coverage from the Beckham County plan on KECO. p OUTDOOR: We booked three outdoor boards for two months in El Reno, Yukon and Mustang.

2 | CREATIVE

p PRINT: The Safe Sleep artwork ran four times across two local newspapers the weeks of April 29 and May 6. All ads were tagged with the Canadian County Health Department logo. p RADIO: We ran the Preterm Birth and Safe Sleep radio spots at an even rotation on KWEY during the month of May. p OUTDOOR: Two Preconception and one Preterm Birth Outdoor board ran in this community for the months of May and June. Each board was tagged with the Canadian County Health Department logo.

3 | IMPRESSIONS

p ACTUAL COST OF PLAN: $3,587.96 p Total Net of Media: $3,317.96 p Total Net of Production: $270.00

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

p More than 290,861 impressions were delivered across all media over the duration of the plan. Impressions are estimated based on the media as it was booked. - Print advertising earned a total of 16,761 impressions. The breakout per newspaper is below: Yukon Review: 12,990 impressions Mustang News: 3,771 impressions - Radio booked with KWEY delivered 93,100 impressions over the four- week flight. - Three outdoor boards earned a total of 181,000 impressions over the two- month period they were displayed. The locations are listed below: El Reno location: 3,273 impressions/week Yukon location: 7,987 impressions/week Mustang location: 11,376 impressions/week

confidential October 2013

Oklahoma State Department of Health FHS-13-01 Canadian, Custer, Washita County Community Plans Prepared by VI Marketing and Branding - Confidential - May 21, 2013 - ACTUALS Circulation/ April May June Average Total NET Total Subscribers/ Frequency Medium Traffic 1 8 15 22 29 6 13 20 27 3 10 17 24 Cost/CPP Cost Billing Demo: pregnant women/young mothers PRINT Yukon Review 4,330 2 $358.82 $667.06 $567.00 Mustang News 1,257 2 $282.34 $564.68 $479.98

RADIO KWEY-FM (Country/95.5) 7,000 60 $21.00 $1,260.00 $1,071.00 KECO spill from Beckham Co.

OUT OF HOME El Reno- 2600 Sunset, NS/EF 3,273 2 $235.29 $470.58 $400.00 Yukon- 1511 S Czech Hall Rd. WS 7,987 2 $235.29 $470.58 $400.00 Mustang- 601 N Mustang Rd. WS 11,376 2 $235.29 $470.58 $400.00

Plans are based on planning cost and are subject to change. Bonus will be negotiated upon placement of radio and out of home. Canadian County is covered by OKC Metro radio. TOTAL $3,903.48 Outdoor production will be $270. Less 15% $3,317.98

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Cleveland 1 | MEDIA PLAN

p BUDGET: $14,000 p OUTDOOR: We booked six total boards. Two boards rotated each month for a total of three months. This staggered approach allowed the community to display their boards in more locations without incurring additional production costs. The last two locations were negotiated as bonus—a full four weeks of exposure for free. p THEATER: We booked two months of theater advertising in two theaters: Robinson 6 Crossing and Spotlight 14. 30-second PSAs ran in the lobby of each theater.

2 | CREATIVE

p OUTDOOR: Preconception and Safe Sleep outdoor vinyls were produced and placed in six locations over a three-month period between May and July. Both boards were tagged with the local coalition’s Facebook page. p THEATER: The Safe Sleep and Smoking Cessation PSAs ran on an even rotation in the purchased theaters. The PSAs were tagged with the local coalition’s Facebook page.

3 | IMPRESSIONS

p ACTUAL COST OF PLAN: $14,002.00 p Total Net of Media: $11,536.00 p Total Net of Production: $2,466.00 p More than 22,647,900 impressions were delivered across all media over the duration of the plan. Impressions are estimated based on the media as it was booked. - Two outdoor boards rotated and were displayed at a total of six locations, earning more than 22,560,000 impressions across all boards over the course of the three-month flight. Each month’s impressions are below: May: 306,155 impressions per week (x4 weeks)

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

June: 489,324 impressions per week (x4 weeks) July: 350,666 impressions per week (x4 weeks) Two theaters were booked on this plan. More than 87,900 impressions are estimated for both theaters over the two-month flight. Note: We have requested a post report from National Cinemedia on the actual delivery of each theater. However, it takes two weeks to get this report. The impressions above are estimated based on the attendance numbers at the time the contract was executed.

confidential October 2013

Oklahoma State Department of Health FHS-13-01 Cleveland County Community Media Plan Prepared by VI Marketing and Branding - Confidential - May 22, 2013 - Actuals May June July Average NET Total Impressions/ Frequency Total Cost Medium Attendance 29 6 13 20 27 3 10 17 24 1 8 15 22 Cost/CPP Billling Demo: pregnant women/young mothers

OUT OF HOME Lamar boards S. I-35 0.4 mi. n/o Hwy 9, ESNF 141,764 1 $1,411.76 $1,411.76 $1,200.00 I-35 0.1 mi. n/o 19th- Moore, WSSF 164,391 1 $3,764.71 $3,764.71 $3,200.00 1710 S. I-35 0.2 mi. n/o NW 12th, ESNF 356,560 1 $4,411.76 $4,411.76 $3,750.00 I-35 S. 0.5 mi. s/o Hwy 9, ESNF 141,764 1 $1,411.77 $1,411.77 $1,200.00 S. I-35 0.2 mi. s/o NE 27th (Exit 119B), WSSF 235,878 Bonus I-35 S. 0.5 mi. s/o Hwy 9, ESNF 114,788 Bonus

Cinema 8 $321.47 $2,571.76 $2,186.00 Robinson 6 Crossing 15,640 Spotlight 14 28,318 LEN Regional :30 (lobby) Lamar production cost will be $2,466- in addition to the above totals. Budget $14,000.00 Production for theater will be $500 and is included in the above total. Media $11,536.00 Total $13,571.76 Production $2,466.00 Less 15% $11,536.00 Difference -$2.00

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Hughes 1 | MEDIA PLAN

p BUDGET: $1,000 p PRINT: A total of eight quarter-page ads were paid for on this plan in two newspapers: The Hughes County Times and The Holdenville News. Hughes County and Okfuskee County shared the cost of six weeks of ads in The Hughes County Times; Hughes County paid for the first three weeks of the run, and Okfuskee paid for the remaining three weeks. A total of 11 print ads ran between the two papers.

2 | CREATIVE

p PRINT: For all eight runs in May and June 2013, Hughes County ran the Generic print ad artwork tagged with information regarding the Hughes Countywide Baby Shower event.

3 | IMPRESSIONS

p ACTUAL COST OF PLAN: $995.25 (No production cost on this plan) p More than 22,900 impressions were delivered in two newspapers over the duration of the flight. Impressions are estimated based on the media as it was booked. The breakout for each newspaper is below: - Hughes County Times: 7,983 impressions - Holdenville News: 15,000 impressions

confidential October 2013

Oklahoma State Department of Health

FHS-13-01 Hughes County Communtiy Media Plan Prepared by VI Marketing and Branding - Confidential - May 16, 2013 - ACTUALS Circulation/ May June Average NET Total Subscribers/ Frequency Total Cost Cost/CPP Billing Medium Traffic 29 6 13 20 27 3 10 17 24 Demo: pregnant women/young mothers PRINT (1/4 page, color) Holdenville Tribune (Wed) 774 0 $174.12 $0.00 Hughes County Times (Thur) 1,774 16 23 30 3 $174.12 $522.36 $444.00 Holdenville News (Sun/Wed-b/w) 2,000 12 19 26 2 5 5 $129.71 $648.55 $551.25

Budgets are based on planning rates and are subject to change June 6th Baby Shower Event Print Print from Okfuskee Co. Plan Total $1,170.91 The number in the yellow box indicated insertaion dates. Less 15% $995.25

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Kingfisher 1 | MEDIA PLAN

p BUDGET: $2,500 p THEATER: We booked three months of theater advertising with the 89er Theater in Kingfisher. p OUTDOOR: We booked one outdoor board in Kingfisher for three consecutive months from May 13 through August 10.

2 | CREATIVE

p THEATER: The Generic Theater slide with the tag “Brought to you by the Kingfisher County Health Department” ran for three months at the 89er Theater. p OUTDOOR: The Generic outdoor board design tagged with Kingfisher County Health Department was installed and remained displayed for three months.

3 | IMPRESSIONS

p ACTUAL COST OF MEDIA PLAN: $1,560.00 p Total Net of Media: $1,275.00 p Total Net of Production: $285.00 p More than 427,000 impressions were delivered across both mediums over the duration of the three-month flight. Impressions are estimated based on the media as it was booked. - Theater advertising delivered 11,375 impressions over the three-month period. - The outdoor board booked in Kingfisher earned 32,000 impressions per week for a total of 415,000 impressions over the course of the run.

confidential October 2013

Oklahoma State Department of Health

FHS-13-01 Kingfisher County Community Media Plans Prepared by VI Marketing and Branding - Confidential - May 17, 2013 - ACTUALS Circulation/ May June July August Average NET Total Subscribers/ Frequency Total Cost Medium Traffic 29 6 13 20 27 3 10 17 24 1 8 15 22 29 5 12 19 Cost/CPP Billing Demo: pregnant women/young mothers

OUT OF HOME 89er Theater-Kingfisher 875/wk 3 $147.06 $441.18 $375.00

Keleher Outdoor Hwy 81 3 mi. n/o Kingfisher WSSF 6,400 3 $352.94 $1,058.82 $900.00

Total based on plannng cost and is subject to change. Production for Keleher Outdoor will be $285. Totals will be split between May and June. Total $1,500.00 Less 15% $1,275.00

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Logan 1 | MEDIA PLAN

p BUDGET: $2,500 p OUTDOOR: We booked two outdoor boards in Guthrie for three months. Creative stayed up for an additional two months at no charge as added value.

2 | CREATIVE

p OUTDOOR: Both of the Guthrie outdoor boards displayed the Preterm Birth artwork with the tag “Logan County Health Department.”

3 | IMPRESSIONS

p ACTUAL NET COST OF MEDIA PLAN: $1,400.00 p Total Net of Media: $1,200.00 p Total Net of Production: $200.00 p More than 691,600 impressions were delivered across both boards over the duration of the flight. Impressions are estimated based on the media as it was booked. Each board’s impressions are outlined below: - Guthrie 413 S. Division: 33,711 impressions per week (x15 weeks) - Guthrie 601 W. Noble: 9,516 impressions per week (x15 weeks)

confidential October 2013

Oklahoma State Department of Health

FHS-13-01 Logan County Community Media Plan Prepared by VI Marketing and Branding - Confidential - May 17, 2013 - ACTUALS Circulation/ May June July August Average NET Total Subscribers/ Frequency Total Cost Cost/CPP Billing Medium Traffic 29 6 13 20 27 3 10 17 24 1 8 15 22 29 5 12 19 Demo: pregnant women/young mothers

OUT OF HOME Lamar Guthrie -413 S. Division WSNF 33,711 3 $235.29 $705.87 $600.00 Guthrie -601 W. Noble SSWF 9,516 3 $235.29 $705.87 $600.00

Total based on planning rate and is subject to change. All contracts will bill totals split over May and June. Production for all boards is estimated at $200. Total $1,411.76 Bonus- creative will stay up through Sept. 10th. Less 15% $1,200.00

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: McCurtain, Choctaw, Bryan, and Pushmataha 1 | MEDIA PLAN

p BUDGET: $12,000 p PRINT: A quarter-page, full-color ad ran one time a week for four weeks in each of the following publications: McCurtain County Gazette, Hugo Daily News, Antlers American and Durant Democrat. Ads were booked in the weeks leading up to each county’s Community Baby Shower. p RADIO: Five radio stations were booked at about 17 paid spots per week. KKBI, KITX, KBEL, KDOE and KBLC stations were scheduled in the weeks leading up to each county’s community baby shower. Each station ran a matching bonus schedule along with the paid schedule, averaging 170 spots per station for each five-week flight.

2 | CREATIVE

p PRINT: Each of the following four ads ran once in each newspaper: Generic, Preconception, Preterm Birth and Safe Sleep. Each ad was tagged with the corresponding county’s Community Baby Shower event information and grantee tag. p RADIO: The pre-produced Safe Sleep and Preconception radio spots played on an even rotation across all reserved radio stations. Each ad was tagged with the corresponding county’s Community Baby Shower event information and grantee tag.

3 | IMPRESSIONS

p ACTUAL COST OF PLAN: $12,010.42 (No production cost) p More than 3,342,800 impressions were delivered across all media over the length of the flight. Impressions are estimated based on the media as it was booked.

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

- Print advertising in four newspapers delivered a total of 89,647 impressions. The breakout of impressions per newspaper is below: McCurtain County Democrat: 39,997 impressions Hugo Daily News: 10,518 impressions Antlers American: 13,146 impressions Durant Democrat: 25,986 impressions - Radio was booked on five stations, delivering 3,253,200 impressions from all stations combined. The breakout per station is below: KKBI: 776,700 impressions KITX: 937,900 impressions KBEL: 351,700 impressions KDOE: 102,600 impressions KLBC: 1,084,400 impressions

confidential October 2013

Oklahoma State Department of Health

FHS-13-01 McCurtain/Choctaw/Bryan/Pushmataha County Community Media Plans Prepared by VI Marketing and Branding - Confidential - May 20, 2013 - ACTUALS April May June Average Total NET Biling Medium Cirtulation/Reach Frequency 1 8 15 22 29 6 13 20 27 3 10 17 24 Cost/CPP Cost Total Demo: pregnant women/young mothers PRINT (1/4 pg, color) McCurtain County Daily Gazette (Sun/Wed) Sun-6,980/Wed-5,725 5 12 19 22 4 $404.12 $1,616.48 $1,374.00 Hugo Daily News (Mon/Choctaw Co.) 1,753 1 6 13 20 4 $432.35 $1,729.40 $1,470.00 Antlers American (Thu/Pushmataha Co.) 2,191 16 23 30 6 4 $202.35 $809.40 $688.00 Durant Democrat (Sun/Bryan Co.) 4,331 26 2 9 12 4 $642.35 $2,569.40 $2,184.00

RADIO (:30, M-F, 6a-7p) KKBI-FM (106.1/Country/McCurtain Co.) 9,600 85 $9.12 $775.20 $658.92 KITX-FM (95.5/Country/McCurtain Co) 4,600 85 $18.00 $1,530.00 $1,300.50 KBEL-FM (102.9/AC/McCurtain Co) 3,300 85 $15.00 $1,275.00 $1,083.75 KDOE-FM (102.3/AC/Pushmataha Co.) 2,900 85 $15.00 $1,275.00 $1,083.75 KBLC-FM (106.3/Country/BryanCo.) 13,200 85 $30.00 $2,550.00 $2,167.50

Totals are based on planning rates and are cubject to change. Matching bonus spots will be negotaited upon booking radio. McCurtain County Baby Shower May 23rd. Total $14,129.88 Chocotaw County Baby Shower May 23rd. Less 15% $12,010.42 Pushmataha County Baby Shower June 6th. Bryan County Baby Shower June 14th. The number in the yellow box indicates the date of insertion.

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Okfuskee 1 | MEDIA PLAN

p BUDGET: $1,000 p PRINT: We booked six total ads in two newspapers: The Hughes County Times and The Okemah News Leader. Okfuskee County split the cost for a six-week run in the Hughes County Times, paying for the last three weeks of the run.

2 | CREATIVE

p PRINT: For all six runs in June 2013, Okfuskee County ran the Generic print ad artwork tagged with information regarding the Okfuskee Countywide Baby Shower event.

3 | IMPRESSIONS

p ACTUAL COST OF PLAN: $939.00 (no production cost on this plan) p More than 19,400 impressions were delivered between two newspapers over a three-week period. Impressions are estimated based on the media as it was booked. Each newspaper’s impressions are outlined below: - Okemah News Leader: 11,425 impressions - Hughes County Times: 7,983 impressions

confidential October 2013

Oklahoma State Department of Health FHS-13-01 Okfuskee County Community Media Plan Prepared by VI Marketing and Branding - Confidential - May 16, 2013 - ACTUALS Circulation/ May June Average NET Total Subscribers/ Frequency Total Cost Cost/CPP Billing Medium Traffic 29 6 13 20 27 3 10 17 24 Demo: pregnant women/young mothers

PRINT Okemah News Leader (Sat/Wed) 2,539 8 15 19 3 $194.12 $582.36 $495.00 Hughes County Times (Thur) 1,774 6 13 20 3 $174.12 $522.36 $444.00

Total based on planning rates and is subject to change. Print Print from Hughes Co. Plan June 20th Baby Shower Event The number in the yellow box indicates insertion date for that week. TOTAL $1,104.72 Less 15% $939.00

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

COMMUNITY: Stephens 1 | MEDIA PLAN

p BUDGET: $4,314 p PRINT: We booked three quarter-page, color ads in The Duncan Banner for Stephens County. p RADIO: We ran six weeks of radio ads at 15 paid spots per week on KKEN. KKEN also ran a matching bonus schedule along with the paid schedule for a total of 180 spots over the six-week flight. p OUT OF HOME: We reserved an outdoor board through Arnold Outdoor at the Duncan Y (Hwy 81 & Hwy 7). The community was also able to negotiate a free looping video in the Duncan Regional Hospital as well for three months.

2 | CREATIVE

p PRINT: Stephens County ran a different ad each week in May 2013. The Generic, Safe Sleep and Preconception print ads tagged with the Stephens County Health Department logo and website ran in the Duncan Banner. p RADIO: The Safe Sleep radio spot tagged with “Brought to you by the Stephens County Health Department” ran on KKEN. p OUT OF HOME: Arnold Outdoor produced and installed the Preconception outdoor art tagged with the Stephens County Health Department logo and website at the Duncan Y. The Duncan Regional Hospital ran a video loop showing the Generic, Safe Sleep and Preterm Birth theater slides tagged with the Stephens County Health Department logo and website.

3 | IMPRESSIONS

p ACTUAL COST OF PLAN: $3,778.52 p Total Net of Media: $3,328.52 p Total Net of Production: $450.00

confidential October 2013

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

p More than 822,350 impressions were delivered across all media over the duration of the flight. Impressions are estimated based on the media as it was booked. - Print advertising in The Duncan Banner delivered 22,122 impressions. - Radio advertising on KKEN earned 217,200 impressions. - Outdoor advertising was booked at the Duncan Y and earned 583,000 impressions over the course of the three-month period. - Note: Video loop advertising was donated to the community by the Duncan Regional Hospital. Because we did not work with the hospital to book this, we do not have impression data for the hospital.

confidential October 2013

Oklahoma State Department of Health FHS-13-01 Stephens County Community Media Plan Prepared by VI Marketing and Branding - Confidential - May 20, 2013 - Actuals April May June July Average Total Circulation/ Frequency NET Total Medium Reach/Traffic 1 8 15 22 29 6 13 20 27 3 10 17 24 1 8 15 22 Cost/CPP Cost Billing Demo: pregnant women/young mothers PRINT (1/4 pg, color, 2x/wk) Duncan Banner (Sun) 4,916 3 $444.71 $1,334.13 $1,134.00

RADIO (:30, M-F , 6a-7p) KKEN-FM (97.1/Country) 3,600 90 $13.00 $1,170.00 $994.50

OUT OF HOME Arnold Outdoor 3 $470.59 $1,411.77 $1,200.00 Hwy 81 & Hwy 7, Duncan Y 8,970

Duncan Regional Hospital (loop) In-kind

Totals based on planning rates and are subject to change. Bonus spots will be negotiated upon booking. Production for outdoor board is $450. TOTAL $3,915.90 LESS 15% $3,328.50

OSDH . FHS-13-01 . Community Infant Mortality Plans Evaluation

1 | GLOSSARY OF MEDIA TERMS:

p Added Value (Bonus) – free ads or services for commitment to a schedule or contract p Circulation – The number of copies of a print publication sold or distributed p Earned Rates (Frequency Rates) – discounted rates based on the over all volume or frequency of a schedule p Flight – the period in which an advertising campaign runs p Frequency – the number of times a person is exposed to a message within a schedule p Impression –an estimate of the average audience that sees or hears the message p Media/Mediums – newspaper, radio, billboards, TV, cable, internet p Outdoor – signage typically near an interstate or other roadway and can be any size of billboard, junior boards or poster boards p Pick-up rates – discounted rate applied when running the same ad with in a 7 day period, applies to print ads only p Print – local area city/county newspapers, weekly publications run one time each week, daily publications run 6 to 7 days per week p Radio – local area radio stations p Rate card –document stating space or time rates of an advertising medium, includes data of mechanical requirements and deadlines p ROP – Run of Press, print ad can fall anywhere within the publication p ROS – Run of Station, radio spot can run any time from the time the station signs on air to the time they sign off p Traffic – term used with radio stations referring to the creative message that will run for a particular schedule p Transit –any signage on the exterior or interior of a city bus or on bus benches and/or shelters p Vendor – radio station, newspaper, outdoor company selling advertising services

confidential October 2013