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Cain J, Behal M, Richter LM. An Integrative Scoping Review of Behavioral Economics Applications in Higher Education: Opportunities for Academic Pharmacy. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100732. [PMID: 38852679 DOI: 10.1016/j.ajpe.2024.100732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/28/2024] [Accepted: 06/01/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVES This integrative scoping review explores the applications of behavioral economics within higher education, particularly, through the lens of nudging (a concept that leverages insights from economics and psychology to guide individuals' decisions subtly). The primary objective is to provide a broad overview of interventions that use behavioral economics principles and, secondarily, discuss their potential to improve pharmacy education and create a foundation for future research in this area. FINDINGS The review analyzed 89 studies that applied behavioral economics principles in higher education settings. Reminders and prompts were the most frequently used principles, with generally positive outcomes, especially in enrollment management. Framing, incentives, and salience also demonstrated effectiveness, depending on the context. Social norms and simplification showed mixed results, whereas priming, loss aversion, feedback, comparison, and commitment had varying degrees of success in influencing behavior. SUMMARY Behavioral economics principles offer valuable insights and tools for enhancing various aspects of education. The review highlights the potential for using these principles to improve student engagement, enrollment processes, and health and well-being initiatives. However, it emphasizes the importance of context-specific design and careful implementation when applying these interventions. Future research opportunities exist to further explore the applications of behavioral economics in pharmacy education and beyond.
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Affiliation(s)
- Jeff Cain
- University of Kentucky College of Pharmacy, Department of Pharmacy Practice & Science, Lexington, KY, USA.
| | - Michael Behal
- University of Tennessee Medical Center, Department of Pharmacy, Knoxville, TN, USA
| | - Lisa M Richter
- North Dakota State University College of Health and Human Sciences, Department of Pharmacy Practice, Fargo, ND, USA
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Abstract
Purpose of Review To explore relations between behavioral economic demand for cannabis and cannabis use disorder (CUD). Prior reviews have focused on drug demand in relation to use outcomes more generally. Complementing and enhancing prior work synthesizing research on cannabis demand, the present review endeavors to determine whether specific demand indices derived from the marijuana purchase task are most reliably related to CUD. Additionally, sociodemographic characteristics of participants in these studies were reviewed to identify whether certain populations were underrepresented in behavioral economic cannabis research. Recent Findings Behavioral economic demand is related to CUD; intensity and elasticity of cannabis demand were consistently associated with CUD diagnosis and severity. However, frequently, only select demand indices were assessed or reported, precluding the ability to confirm which indices are superior for denoting CUD risk. Further, most studies enrolled samples that were predominately young adults, Caucasian, and male. Summary As CUD becomes more prevalent in the wake of cannabis legalization, identification of robust predictors of CUD risk is paramount. Cannabis demand is consistently associated with CUD; however, individual indices of import in this relationship remain ambiguous. Subsequent research is needed to confirm index-specific markers of disordered cannabis use, and whether links between demand and CUD generalize across diverse populations.
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Affiliation(s)
- Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box GS121-5, Providence, RI 02912, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Heath, Providence, RI 02912, USA
| | - Benjamin L. Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box GS121-5, Providence, RI 02912, USA
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Free Sugars Intake among Chinese Adolescents and Its Association with Dental Caries: A Cross-Sectional Study. Nutrients 2021; 13:nu13030765. [PMID: 33652968 PMCID: PMC7996778 DOI: 10.3390/nu13030765] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
This study aims to estimate the free sugars intake, identify the primary food sources of free sugars, and explore the relationship between free sugars intake and dental caries among Chinese adolescents. This cross-sectional study included 1517 middle-school students aged 12–14 years in Changsha city, China. Adolescents completed a 12-item Food Frequency Questionnaire (FFQ) and oral health assessment. The students’ dental caries experience was available as DMFT score (number of decayed, missing, and filled permanent teeth). Statistical analyses included the Mann–Whitney test, Kruskal–Wallis test, Chi-square test, and binary logistic regression model. The average intake of free sugars was 53.1 g/d in adolescents, and 43.2% of the students consumed more than 50 g of free sugars daily. The primary contributor to free sugars was sugar-sweetened beverages (SSBs). Age, boarders, and high family income were risk factors for excessive free sugars intake (p < 0.05), and increased free sugars intake was a risk factor for dental caries (odds ratio, OR = 1.446, 95% confidence interval: 1.138–1.839). Both the free sugars intake and dental caries prevalence in Chinese adolescents were high. Targeted interventions are urgently needed to address the excessive consumption of free sugars and improve Chinese adolescents’ oral health.
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Pfinder M, Heise TL, Hilton Boon M, Pega F, Fenton C, Griebler U, Gartlehner G, Sommer I, Katikireddi SV, Lhachimi SK. Taxation of unprocessed sugar or sugar-added foods for reducing their consumption and preventing obesity or other adverse health outcomes. Cochrane Database Syst Rev 2020; 4:CD012333. [PMID: 32270494 PMCID: PMC7141932 DOI: 10.1002/14651858.cd012333.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Global prevalence of overweight and obesity are alarming. For tackling this public health problem, preventive public health and policy actions are urgently needed. Some countries implemented food taxes in the past and some were subsequently abolished. Some countries, such as Norway, Hungary, Denmark, Bermuda, Dominica, St. Vincent and the Grenadines, and the Navajo Nation (USA), specifically implemented taxes on unprocessed sugar and sugar-added foods. These taxes on unprocessed sugar and sugar-added foods are fiscal policy interventions, implemented to decrease their consumption and in turn reduce adverse health-related, economic and social effects associated with these food products. OBJECTIVES To assess the effects of taxation of unprocessed sugar or sugar-added foods in the general population on the consumption of unprocessed sugar or sugar-added foods, the prevalence and incidence of overweight and obesity, and the prevalence and incidence of other diet-related health outcomes. SEARCH METHODS We searched CENTRAL, Cochrane Database of Systematic Reviews, MEDLINE, Embase and 15 other databases and trials registers on 12 September 2019. We handsearched the reference list of all records of included studies, searched websites of international organisations and institutions, and contacted review advisory group members to identify planned, ongoing or unpublished studies. SELECTION CRITERIA We included studies with the following populations: children (0 to 17 years) and adults (18 years or older) from any country and setting. Exclusion applied to studies with specific subgroups, such as people with any disease who were overweight or obese as a side-effect of the disease. The review included studies with taxes on or artificial increases of selling prices for unprocessed sugar or food products that contain added sugar (e.g. sweets, ice cream, confectionery, and bakery products), or both, as intervention, regardless of the taxation level or price increase. In line with Cochrane Effective Practice and Organisation of Care (EPOC) criteria, we included randomised controlled trials (RCTs), cluster-randomised controlled trials (cRCTs), non-randomised controlled trials (nRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies. We included controlled studies with more than one intervention or control site and ITS studies with a clearly defined intervention time and at least three data points before and three after the intervention. Our primary outcomes were consumption of unprocessed sugar or sugar-added foods, energy intake, overweight, and obesity. Our secondary outcomes were substitution and diet, expenditure, demand, and other health outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened all eligible records for inclusion, assessed the risk of bias, and performed data extraction.Two review authors independently assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We retrieved a total of 24,454 records. After deduplicating records, 18,767 records remained for title and abstract screening. Of 11 potentially relevant studies, we included one ITS study with 40,210 household-level observations from the Hungarian Household Budget and Living Conditions Survey. The baseline ranged from January 2008 to August 2011, the intervention was implemented on September 2011, and follow-up was until December 2012 (16 months). The intervention was a tax - the so-called 'Hungarian public health product tax' - on sugar-added foods, including selected foods exceeding a specific sugar threshold value. The intervention includes co-interventions: the taxation of sugar-sweetened beverages (SSBs) and of foods high in salt or caffeine. The study provides evidence on the effect of taxing foods exceeding a specific sugar threshold value on the consumption of sugar-added foods. After implementation of the Hungarian public health product tax, the mean consumption of taxed sugar-added foods (measured in units of kg) decreased by 4.0% (standardised mean difference (SMD) -0.040, 95% confidence interval (CI) -0.07 to -0.01; very low-certainty evidence). The study was at low risk of bias in terms of performance bias, detection bias and reporting bias, with the shape of effect pre-specified and the intervention unlikely to have any effect on data collection. The study was at unclear risk of attrition bias and at high risk in terms of other bias and the independence of the intervention. We rated the certainty of the evidence as very low for the primary and secondary outcomes. The Hungarian public health product tax included a tax on sugar-added foods but did not include a tax on unprocessed sugar. We did not find eligible studies reporting on the taxation of unprocessed sugar. No studies reported on the primary outcomes of consumption of unprocessed sugar, energy intake, overweight, and obesity. No studies reported on the secondary outcomes of substitution and diet, demand, and other health outcomes. No studies reported on differential effects across population subgroups. We could not perform meta-analyses or pool study results. AUTHORS' CONCLUSIONS There was very limited evidence and the certainty of the evidence was very low. Despite the reported reduction in consumption of taxed sugar-added foods, we are uncertain whether taxing unprocessed sugar or sugar-added foods has an effect on reducing their consumption and preventing obesity or other adverse health outcomes. Further robustly conducted studies are required to draw concrete conclusions on the effectiveness of taxing unprocessed sugar or sugar-added foods for reducing their consumption and preventing obesity or other adverse health outcomes.
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Affiliation(s)
- Manuela Pfinder
- AOK Baden‐WürttembergDepartment of Health PromotionPresselstr. 19StuttgartBaden‐WürttembergGermany70191
- University Hospital, University of HeidelbergDepartment of General Practice and Health Services ResearchVossstrasse 2HeidelbergBremenGermanyD‐69115
- University of BremenInstitute for Public Health and Nursing Research, Health Sciences BremenBibliothekstr. 1BremenBremenGermany28359
| | - Thomas L Heise
- University of BremenInstitute for Public Health and Nursing Research, Health Sciences BremenBibliothekstr. 1BremenBremenGermany28359
- Leibniz Institute for Prevention Research and EpidemiologyResearch Group for Evidence‐Based Public HealthAchterstr. 30BremenGermany28359
| | - Michele Hilton Boon
- University of GlasgowMRC/CSO Social and Public Health Sciences UnitGlasgowUK
| | - Frank Pega
- University of OtagoPublic Health23A Mein Street, NewtownWellingtonNew Zealand6242
| | - Candida Fenton
- University of EdinburghUsher Institute of Population Health Sciences and InformaticsMedical SchoolTeviot PlaceEdinburghUKEH8 9AG
| | - Ursula Griebler
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and EvaluationDr.‐Karl‐Dorrek Str. 30KremsAustria3500
| | - Gerald Gartlehner
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and EvaluationDr.‐Karl‐Dorrek Str. 30KremsAustria3500
| | - Isolde Sommer
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and EvaluationDr.‐Karl‐Dorrek Str. 30KremsAustria3500
| | | | - Stefan K Lhachimi
- Leibniz Institute for Prevention Research and EpidemiologyResearch Group for Evidence‐Based Public HealthAchterstr. 30BremenGermany28359
- University of BremenDepartment for Health Services Research, Institute for Public Health and Nursing Research, Health Sciences BremenBibliotheksstr. 1BremenGermany28359
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Development and Validation of the Policies, Opportunities, Initiatives and Notable Topics (POINTS) Audit for Campuses and Worksites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050778. [PMID: 30836633 PMCID: PMC6427413 DOI: 10.3390/ijerph16050778] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 12/22/2022]
Abstract
Background: Workplace or campus wellness/obesity-prevention policies and initiatives can improve health. Research tools to assess worksite or campus policies/initiatives are scarce. Thus, the aim of this research is to develop and validate the policies, opportunities, initiatives, and notable topics (POINTS) audit. Methods: POINTS was developed and refined via expert review, pilot-testing, and field testing. Trained researchers completed a web-based review from a student-focus or employee-focus regarding 34 health-promoting topics for colleges. Each topic was evaluated on a 0⁻2 scale: 0 = no policy/initiative, 1 = initiatives, 2 = written policy. When a written policy was detected, additional policy support questions (administered, monitored, reviewed) were completed. Results: Cronbach's Alpha for the student-focused POINTS audit was α = 0.787 (34 items, possible points = 65), and for the employee-focused POINTS audit was α = 0.807 (26 items, possible points = 50). A total of 115 student-focused and 33 employee-focused audits were completed. Although there was little evidence of policy presence beyond stimulant standards (smoking and alcohol), there were extensive examples of health initiatives. The student-focused POINTS audit was validated using the Healthier Campus Initiative's survey. Conclusions: POINTS is a web-based audit tool that is valid and useful for pre-assessment, advocacy, benchmarking, and tracking policies for health and well-being for students (campus) and employees (worksite).
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Seah SSY, Rebello SA, Tai BC, Tay Z, Finkelstein EA, van Dam RM. Impact of tax and subsidy framed messages on high- and lower-sugar beverages sold in vending machines: a randomized crossover trial. Int J Behav Nutr Phys Act 2018; 15:76. [PMID: 30103793 PMCID: PMC6090625 DOI: 10.1186/s12966-018-0711-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/31/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Framing of fiscal incentives has been suggested to be important in influencing purchase decisions. We aimed to examine the effect of framing a modest price difference between high- and lower-sugar beverages as a tax or a subsidy respectively, using messages placed on vending machines to influence beverage purchases. DESIGN/SETTING This is an 11-week randomized crossover trial conducted between August and November 2015, with a two-week run-in period before intervention, targeted at students, staff and faculty of a university campus in Singapore. Twenty-one beverage vending machines were used to implement the intervention involving 'tax message', 'subsidy message' and 'no message (control)'. The former two messages suggest 'a tax for high sugar beverages' or 'a subsidy for lower sugar beverages' respectively. Prices of the beverages offered were fixed at baseline and remained the same in all three experimental conditions: lower-sugar beverage options were priced ~ 10% lower than the corresponding high-sugar option. The machines were randomized to one of the 6 sequences of intervention. Each message intervention period was 3 weeks. The effect of messages was assessed by comparing average weekly units of beverages sold between interventions using mixed effects model. RESULTS The average weekly units of high and lower-sugar beverages sold per vending machine were 115 and 98 respectively in the control condition. The percentage of high-sugar beverages sold was 54% in the control, 53% in the tax, and 54% in the subsidy message condition. There was no difference in the weekly units of high-sugar beverages sold for the tax message (- 2, 95% CI -8 to 5, p = 0.61) or the subsidy message (0, 95% CI -10 to 10, p = 0.96) conditions as compared with the control condition. Similarly, there was no difference in the weekly units of lower-sugar beverages sold for the tax message (4, 95% CI -4 to 13, p = 0.32) or the subsidy message (7, 95% CI -4 to 18, p = 0.18) conditions as compared with the control condition. CONCLUSIONS The use of tax and subsidy messages to highlight modest price differences did not substantially reduce high-sugar beverage sales in vending machines on an Asian university campus.
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Affiliation(s)
- Sharna Si Ying Seah
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Salome A. Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Investigational Medicine Unit, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Zoey Tay
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Eric Andrew Finkelstein
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Health Services & Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA
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Rosas CE, Gregorio-Pascual P, Driver R, Martinez A, Price SL, Lopez C, Mahler HIM. Effects of Social Norms Information and Self-Affirmation on Sugar-Sweetened Beverage Consumption Intentions and Behaviors. BASIC AND APPLIED SOCIAL PSYCHOLOGY 2018; 39:112-126. [PMID: 29398745 DOI: 10.1080/01973533.2017.1283503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The separate and combined efficacy of a social norms and a self-affirmation intervention to motivate decreased sugar-sweetened beverage (SSB) consumption was examined in two experiments. College students were randomly assigned to receive information about SSB consumption risks, norms, both, or neither. In addition, participants performed either a self-affirmation or control task. Self-affirmation only weakly affected SSB consumption intentions and behaviors. However, participants in Experiment 2 who received risks information, norms information, or both reported greater SSB reduction intentions than did those who received no information. Two-weeks later, those who received both types of information reported more frequent behavior change preparations, and it appears this effect may have been partially mediated by the changes in intentions to reduce SSB consumption.
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Evans KA, Stewart PA, Cook SR, Seplaki CL, Rich DQ, Fernandez ID. The Relative Costs of High- vs. Low-Energy-Density Foods and More vs. Less Healthful Beverages Consumed by Children. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018; 13:240-254. [PMID: 30651904 PMCID: PMC6330706 DOI: 10.1080/19320248.2015.1095145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare grocery costs between relatively high energy density foods and sugar-sweetened/high-fat beverages and lower energy density foods and more healthful beverages in children's diets. METHODS Sixty foods were divided into high and low energy density baskets. Fourteen beverages were designated to either basket based on fat and added-sugar content. Prices were collected at 60 grocery stores and composite costs compared between baskets using Wilcoxon tests. RESULTS The cost per kilogram of high energy density foods was greater, but the cost per quart of sugar-sweetened/high-fat beverages was lower than more healthful beverages. The cost per 1000 calories and the cost per serving of the high energy density basket were lower. CONCLUSIONS The relative cost of high and low energy density foods in children's diets depends on how cost is quantified. "Pound-for-pound," lower energy density foods and more healthful beverages are generally less expensive, but high energy density foods and less healthful beverages are cheaper per serving. Cost metrics including other factors (e.g. time cost) may further clarify the role of grocery prices in children's diets.
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Affiliation(s)
| | - Patricia A Stewart
- Clinical Research Center, 601 Elmwood Avenue, Rochester, NY 14642, University of Rochester School of Medicine and Dentistry,
| | - Steven R Cook
- Department of Pediatrics, 601 Elmwood Avenue, Rochester, NY 14642, University of Rochester School of Medicine and Dentistry,
| | - Christopher L Seplaki
- Department of Public Health Sciences, Division of Epidemiology, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd., CU 420644, Rochester, NY, USA 14642-0644, 585-275-9554,
| | - David Q Rich
- Department of Public Health Sciences, Division of Epidemiology, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd., CU 420644, Rochester, NY, USA 14642-0644, 585-275-9554,
| | - Isabel Diana Fernandez
- Department of Public Health Sciences, Division of Epidemiology, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd., CU 420644, Rochester, NY, USA 14642-0644, 585-275-9554,
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Montuclard AL, Park-Mroch J, O'Shea AMJ, Wansink B, Irvin J, Laroche HH. College Cafeteria Signage Increases Water Intake but Water Position on the Soda Dispenser Encourages More Soda Consumption. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:764-771.e1. [PMID: 28743437 DOI: 10.1016/j.jneb.2017.05.361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To evaluate the effects of improved water location visibility and water dispenser position on the soda dispenser on undergraduate students' beverage choices. METHODS Two focus groups with pilot intervention surveys before and after, adding a small sign above the soda dispensers' water button for 6 weeks in a large US university's all-you-can-eat, prepaid dining hall (measured with chi-square tests and logistic and ordinal logistic regression). RESULTS Focus groups included 15 students. Survey participants included 357 students before and 301 after the intervention. After the intervention, more students reported ever having drunk water with the meal (66.4% to 77.0%; P = .003) and water consumption frequency increased (P = .005). Postintervention, the odds of drinking water increased by 1.57. Preference for other drinks was the main reason for not drinking water. A total of 59% of students had ever changed their preference from water to soda. CONCLUSIONS AND IMPLICATIONS The clear indication of the water's location increased students' reported water consumption. Further investigation is needed into how a non-independent water dispenser influences students' beverage choice. Clearly labeled, independent water dispensers are recommended.
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Affiliation(s)
| | - Jennifer Park-Mroch
- Family Living Programs, University of Wisconsin-Extension, Cooperative Extension, Madison, WI
| | - Amy M J O'Shea
- Department of Internal Medicine, University of Iowa, Iowa City, IA
| | - Brian Wansink
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY
| | - Jill Irvin
- University Housing Administration, Iowa City, IA
| | - Helena H Laroche
- Department of Internal Medicine, University of Iowa, Iowa City, IA.
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Perceived Health and Nutrition Concerns as Predictors of Dietary Patterns among Polish Females Aged 13-21 Years (GEBaHealth Project). Nutrients 2017. [PMID: 28621721 PMCID: PMC5490592 DOI: 10.3390/nu9060613] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Health-related concerns can often be factors influencing health-related behaviours. It remains unclear whether a high level of concerns is associated with pro-healthy or unhealthy dietary behaviours and whether any associations between nutrition-related concerns and dietary behaviours exist in a population of girls and young women. The aim of the study was to investigate the associations between perceived health and nutrition concerns and dietary patterns in a representative sample of Polish young females. Data was collected in 2012 through a cross-sectional quantitative survey within the GEBaHealth (Girls Eating Behaviours and Health) project in a group of 1107 Polish girls aged 13-21 years old. Dietary patterns were identified by Principal Component Analysis (PCA) based on dietary data collected with Food Frequency Questionnaires (FFQs). Nutrition and health concerns were assessed separately by two indices: Health Concern Index (HCI) and Nutrition Concern Index (NCI); both based on the Health Concern Scale (HCS). The associations between perceived health and nutrition concerns and each dietary pattern were investigated using logistic regression analysis. Displaying a higher level of health concerns increased the chances of adherence to the upper tertile of 'Fruit & vegetables' pattern (adjusted odds ratio [adj. ORs]: 1.46, 95% Confidence Interval [95% CI]: 1.02-2.10). Displaying a lower level of health concerns increased the chances of the adherence to the upper tertiles of 'Traditional Polish', 'Dairy & fats', 'Fruit and vegetables' and 'Fast food & sweets' patterns (adj. ORs: 1.87, 95% CI: 1.31-2.67; 1.66, 95% CI: 1.18-2.34; 1.57, 95% CI: 1.11-2.22; 1.52, 95% CI: 1.08-2.13; respectively). No significant associations were found between levels of nutrition concerns and dietary patterns in the adjusted model. We found associations between self-perceived health concerns and dietary patterns in our study sample, suggesting health concerns can be an important predictor of dietary behaviours in girls and young women. To increase the effectiveness of healthy eating, an emphasis should be laid on health, reinforced with awareness of nutrition, when advising on food-related decisions.
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Ježovičová K, Turčínková J, Drexler D. The Influence of Package Attributes on Consumer Perception at the Market With Healthy Food. ACTA UNIVERSITATIS AGRICULTURAE ET SILVICULTURAE MENDELIANAE BRUNENSIS 2017. [DOI: 10.11118/actaun201664061919] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pfinder M, Katikireddi SV, Pega F, Gartlehner G, Fenton C, Griebler U, Sommer I, Heise TL, Lhachimi SK. Taxation of unprocessed sugar or sugar-added foods for reducing their consumption and preventing obesity or other adverse health outcomes. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012333] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Manuela Pfinder
- AOK Baden-Württemberg; Department of Health Promotion/Occupational Health Management; Presselstr. 19 Stuttgart Baden-Württemberg Germany 70191
- University Hospital, University of Heidelberg; Department of General Practice and Health Services Research; Vossstrasse 2 Heidelberg Bremen Germany D-69115
- University of Bremen; Institute for Public Health and Nursing Research, Health Sciences Bremen; Bibliothekstr. 1 Bremen Bremen Germany 28359
| | | | - Frank Pega
- University of Otago; Public Health; 23A Mein Street, Newtown Wellington New Zealand 6242
| | - Gerald Gartlehner
- Danube University Krems; Cochrane Austria; Dr.-Karl-Dorrek-Strasse 30 Krems Austria 3500
| | - Candida Fenton
- University of Glasgow; MRC/CSO Social and Public Health Sciences Unit; Glasgow UK
| | - Ursula Griebler
- Danube University Krems; Department for Evidence-based Medicine and Clinical Epidemiology; Dr.-Karl-Dorrek Str. 30 Krems Austria 3500
| | - Isolde Sommer
- Danube University Krems; Department for Evidence-based Medicine and Clinical Epidemiology; Dr.-Karl-Dorrek Str. 30 Krems Austria 3500
| | - Thomas L Heise
- University of Bremen; Institute for Public Health and Nursing Research, Health Sciences Bremen; Bibliothekstr. 1 Bremen Bremen Germany 28359
- Leibniz Institute for Prevention Research and Epidemiology; Research Group for Evidence-Based Public Health; Achterstr. 30 Bremen Germany 28359
| | - Stefan K Lhachimi
- University of Bremen; Institute for Public Health and Nursing Research, Health Sciences Bremen; Bibliothekstr. 1 Bremen Bremen Germany 28359
- Leibniz Institute for Prevention Research and Epidemiology; Research Group for Evidence-Based Public Health; Achterstr. 30 Bremen Germany 28359
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Heise TL, Katikireddi SV, Pega F, Gartlehner G, Fenton C, Griebler U, Sommer I, Pfinder M, Lhachimi SK. Taxation of sugar-sweetened beverages for reducing their consumption and preventing obesity or other adverse health outcomes. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012319] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Thomas L Heise
- University of Bremen; Institute for Public Health and Nursing Research, Health Sciences Bremen; Bibliothekstr. 1 Bremen Germany 28359
- Leibniz Institute for Prevention Research and Epidemiology; Research Group for Evidence-Based Public Health; Achterstr. 30 Bremen Germany 28359
| | | | - Frank Pega
- University of Otago; Public Health; 23A Mein Street, Newtown Wellington New Zealand 6242
| | - Gerald Gartlehner
- Danube University Krems; Cochrane Austria; Dr.-Karl-Dorrek-Strasse 30 Krems Austria 3500
| | - Candida Fenton
- University of Glasgow; MRC/CSO Social and Public Health Sciences Unit; Glasgow UK
| | - Ursula Griebler
- Danube University Krems; Department for Evidence-based Medicine and Clinical Epidemiology; Dr.-Karl-Dorrek Str. 30 Krems Austria 3500
| | - Isolde Sommer
- Danube University Krems; Department for Evidence-based Medicine and Clinical Epidemiology; Dr.-Karl-Dorrek Str. 30 Krems Austria 3500
| | - Manuela Pfinder
- University of Bremen; Institute for Public Health and Nursing Research, Health Sciences Bremen; Bibliothekstr. 1 Bremen Germany 28359
- Leibniz Institute for Prevention Research and Epidemiology; Research Group for Evidence-Based Public Health; Achterstr. 30 Bremen Germany 28359
- AOK Baden-Württemberg; Department of Health Promotion/Occupational Health Management; Presselstr. 19 Stuttgart Baden-Württemberg Germany 70191
| | - Stefan K Lhachimi
- University of Bremen; Institute for Public Health and Nursing Research, Health Sciences Bremen; Bibliothekstr. 1 Bremen Germany 28359
- Leibniz Institute for Prevention Research and Epidemiology; Research Group for Evidence-Based Public Health; Achterstr. 30 Bremen Germany 28359
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Affiliation(s)
| | - Mark D. DeBoer
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia 22908; ,
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15
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Deliens T, Clarys P, De Bourdeaudhuij I, Deforche B. Correlates of University Students' Soft and Energy Drink Consumption According to Gender and Residency. Nutrients 2015; 7:6550-66. [PMID: 26258790 PMCID: PMC4555137 DOI: 10.3390/nu7085298] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 07/26/2015] [Accepted: 07/31/2015] [Indexed: 11/17/2022] Open
Abstract
This study assessed personal and environmental correlates of Belgian university students' soft and energy drink consumption and investigated whether these associations were moderated by gender or residency. Four hundred twenty-five university students completed a self-reported on-line questionnaire assessing socio-demographics, health status, soft and energy drink consumption, as well as personal and environmental factors related to soft and energy drink consumption. Multiple linear regression analyses were conducted. Students believing soft drink intake should be minimized (individual subjective norm), finding it less difficult to avoid soft drinks (perceived behavioral control), being convinced they could avoid soft drinks in different situations (self-efficacy), having family and friends who rarely consume soft drinks (modelling), and having stricter family rules about soft drink intake were less likely to consume soft drinks. Students showing stronger behavioral control, having stricter family rules about energy drink intake, and reporting lower energy drink availability were less likely to consume energy drinks. Gender and residency moderated several associations between psychosocial constructs and consumption. Future research should investigate whether interventions focusing on the above personal and environmental correlates can indeed improve university students' beverage choices.
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Affiliation(s)
- Tom Deliens
- Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, Pleinlaan 2, Brussels 1050, Belgium.
| | - Peter Clarys
- Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, Pleinlaan 2, Brussels 1050, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, Ghent 9000, Belgium.
| | - Benedicte Deforche
- Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, Pleinlaan 2, Brussels 1050, Belgium.
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, Ghent 9000, Belgium.
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16
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Bogliacino F, Parra Forero IA. Behaviourally designed treatments that increase willingness to treatment from families with children suffering from autism spectrum disorder. J Epidemiol Community Health 2015; 69:958-62. [PMID: 25903754 DOI: 10.1136/jech-2015-205505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/30/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Autism spectrum disorder is a lifelong disability that is not well known by the general population and tends to be associated with social stigma; also, because it involves children, it may get highly emotionally charged. These stylised facts engender a number of possible heuristics and biases at the moment of deciding on following a treatment or looking for a diagnosis, which should be considered in the presentation of information. Using insights from Behavioural Economics, three treatments are designed to present the information regarding possible therapies. METHODS Between-subjects design with one level of variation. Interviews were performed with a convenience sample of 154 households from the metropolitan area of Bogotá (Colombia). The treatments include: use of default option, use of professional interviewer to illustrate the therapy and emotionally charged presentation. RESULTS Kruskal-Wallis test of the intention to be treated rejects the null hypothesis (χ(2)=22.14, p=0.00). The cognitive processing of the information is not a determinant, supporting the claim that genuine framing effects shape the choice. The strongest effect of the treatment with a professional suggests a key role for asymmetry of the information, which is confirmed indirectly through the postexperiment questionnaire. CONCLUSIONS Bad healthcare decisions are not necessarily driven by lack of information. Asymmetric information (eg, delegating the decision to a professional) improves choices, especially when social stigma is involved. Cognitive processing of information seems to be less relevant than the framing effect.
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Maniadakis N, Kapaki V, Damianidi L, Kourlaba G. A systematic review of the effectiveness of taxes on nonalcoholic beverages and high-in-fat foods as a means to prevent obesity trends. CLINICOECONOMICS AND OUTCOMES RESEARCH 2013; 5:519-43. [PMID: 24187507 PMCID: PMC3810203 DOI: 10.2147/ceor.s49659] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND As part of the efforts to curb obesity, a new focus seems to be put on taxing foods that are perceived as being associated with obesity (eg, sugar-sweetened beverages and foods high in fat, sugar, and salt content) as a policy instrument to promote healthier diets. OBJECTIVE To assess the possible effects of such taxation policies by identifying and analyzing all studies which investigate the impact of price increases on consumption, caloric intake, or weight outcomes. METHODS Electronic data bases were searched with appropriate terms and their combinations. Thereafter, abstracts were reviewed and studies were selected based on predefined criteria. The characteristics of the selected studies and the results were extracted in a special form and consequently were reviewed and synthesized. RESULTS Price increase may lead to a reduction in consumption of the targeted products, but the subsequent effect on caloric intake may be much smaller. Only a limited number of the identified studies reported weight outcomes, most of which are either insignificant or very small in magnitude to make any improvement in public health. CONCLUSION The effectiveness of a taxation policy to curb obesity is doubtful and available evidence in most studies is not very straightforward due to the multiple complexities in consumer behavior and the underling substitution effects. There is need to investigate in-depth the potential underlying mechanisms and the relationship between price-increase policies, obesity, and public health outcomes.
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Affiliation(s)
- Nikolaos Maniadakis
- Department of Health Services Organization and Management, National School of Public Health, Athens, Greece
| | - Vasiliki Kapaki
- Department of Health Services Organization and Management, National School of Public Health, Athens, Greece
- University of Peloponnese, Peloponnese, Greece
| | - Louiza Damianidi
- Department of Allergy, Second Pediatric Clinic, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Georgia Kourlaba
- The Stavros Niarchos Foundation – Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), First and Second Departments of Pediatrics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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Validating a behavioral economic approach to assess food demand: Effects of body mass index, dietary restraint, and impulsivity. Appetite 2012; 59:364-71. [DOI: 10.1016/j.appet.2012.05.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 05/19/2012] [Accepted: 05/21/2012] [Indexed: 01/20/2023]
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19
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Epstein LH, Jankowiak N, Nederkoorn C, Raynor HA, French SA, Finkelstein E. Experimental research on the relation between food price changes and food-purchasing patterns: a targeted review. Am J Clin Nutr 2012; 95:789-809. [PMID: 22378726 PMCID: PMC3302358 DOI: 10.3945/ajcn.111.024380] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
One way in which to modify food purchases is to change prices through tax policy, subsidy policy, or both. We reviewed the growing body of experimental research conducted in the laboratory and in the field that investigates the following: the extent to which price changes influence purchases of targeted and nontargeted foods, total energy, or macronutrients purchased; the interaction of price changes with adjunctive interventions; and moderators of sensitivity to price changes. After a brief overview of economic principles and observational research that addresses these issues, we present a targeted review of experimental research. Experimental research suggests that price changes modify purchases of targeted foods, but research on the overall nutritional quality of purchases is mixed because of substitution effects. There is mixed support for combining price changes with adjunctive interventions, and there are no replicated findings on moderators to price sensitivity in experiments. Additional focused research is needed to better inform food policy development with the aim of improving eating behavior and preventing obesity.
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Affiliation(s)
- Leonard H Epstein
- University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14214-3000, USA.
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