Emolabeling increases healthy food choices among grade school children in a structured grocery aisle setting

Health Literacy in Early Childhood: A Systematic Review of Empirical Studies

Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013–2022. Results show that research focuses on different domains of health literacy for children. In relation to children’s food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents’ knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children’s health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy.

Disgusting Face, Disease-Ridden Place?: Emoji Influence on the Interpretation of Restaurant Inspection Reports

Every year, millions of Americans get sick from foodborne illness and it is estimated half of all reported instances occur at restaurants. To protect the public, regulators are encouraged to conduct restaurant inspections and disclose reports to consumers. However, inspection reporting format is inconsistent and typically contains information unclear to most consumers who often misinterpret the inspection results. Additionally, consumers are increasingly searching for this information in a digital context. Limited research explores inspection reports as communication tools. Using affect-as-information and ELM as theoretical frameworks, this experiment investigated how discrete emotions (e.g., disgust) conveyed through pictorial cues (i.e., emojis) influenced consumers' processing of inspection reports. Participants, recruited from Amazon's MTurk, were randomly assigned to one of six experimental conditions in a 3 (emoji: smiling vs. disgusted vs. none) x 2 (violation level: low vs. high) between-subjects design. Then, participants completed a questionnaire regarding perceptions and cognitive processing of the message. Results revealed that, compared to text, disgusted face emoji increased risk perceptions and avoidance behavior. In terms of emotion, smiling face emoji motivated participants to feel more emotions related to sanitation. In turn, positive feelings decreased elaboration likelihood. As predicted by ELM, involvement also predicted elaboration, such that participants who were highly involved with inspection reports elaborated more than those less involved. Involvement also moderated the relationship between emoji presented and elaboration. Practical implications are also discussed.

Impact of a front-of-pack nutritional traffic-light label on the nutritional quality and the hedonic value of mid-afternoon snacks chosen by mother-child dyads

The aim of this study was to assess the impact of a nutritional traffic-light label, the Nutri-Score, on snack choices in mother-child dyads and to assess a potential hedonic cost associated with a change in favour of healthier choices. French mothers and children (n = 95; children's age: 7-11 years) who participated were asked to choose, for themselves and for the other dyad member, a snack composed of one beverage and two food items selected among several products with different nutritional quality. In the first step, the products were presented without any information. In the second step, the products were labelled with the Nutri-Score. Mothers and children were asked to rate their liking for all proposed products before being informed of their nutritional quality. The nutritional quality, the hedonic score, and the estimated budget of the selected snacks were compared before and after labelling. As hypothesized, the Nutri-Score label led to a significant increase in the nutritional quality of the chosen snacks. The budget for the chosen snacks was unchanged or decreased after the nutritional labelling was applied. Children and mothers had significantly lower liking for the snacks after nutritional labelling than before nutritional labelling, suggesting a hedonic cost associated with a change in favour of healthier snack choices. This raises the question of the sustainability of the behavioural change induced by the Nutri-Score label.

Can front-of-pack nutrition labeling influence children's emotional associations with unhealthy food products? An experiment using emoji

Food products targeted at children are usually marketed using persuasive elements aimed at creating positive hedonic and emotional associations. For this reason, changes in children's emotional associations with unhealthy food products can discourage their consumption. In this context, the aim of the present study was to compare children's emotional associations with food products featuring different front-of-pack (FOP) nutrition labelling schemes. A total of 492 children (6-12 years old) were randomly divided into three groups, each of which evaluated a series of packages featuring different FOP nutrition labelling schemes: guidelines daily amount (GDA), traffic light system (TLS) and nutritional warnings. For each of the six packages and three unpackaged products, children were asked to select all the emoji from a list that described how they would feel eating the product. Data were analyzed using generalized linear models. FOP nutrition labelling significantly influenced the frequency of use five of the 16 emoji. In general, children who evaluated packages with directive and semi-directive schemes used emoji associated with positive emotions less frequently than those who evaluated packages with the GDA system. The effect of FOP nutrition labelling scheme on emotional associations was moderated by age and type of school. The effect of directive and semi-directive FOP nutritional schemes, in special nutritional warnings, tended to be higher for younger children and children from public schools. These results suggest that FOP nutrition labelling may contribute to discouraging consumption of products with high content of nutrients associated with non-communicable diseases among children.

Influence of Label Design on Children's Perception of 2 Snack Foods

OBJECTIVE

To evaluate the influence of label design on children's perception of 2 popular snack foods across 3 income levels.

DESIGN

Labels of 2 snack products (yogurt and sponge cake) were designed using a fractional factorial design with 3 2-level variables: cartoon character, nutrition claims, and front-of-package nutritional information.

PARTICIPANTS

A total of 221 children (aged 9-13 years) from Montevideo, Uruguay, with different income levels, participated in the study.

MAIN OUTCOME MEASURES

Children's attitude toward and liking of 2 food products.

RESULTS

Low-income children showed a more positive attitude toward the products than did middle- and high-income children. The inclusion of a cartoon character in sponge cake labels significantly affected hedonic expectations regardless of income. Middle- and high-income children tended to use the term funny more frequently and the term boring less frequently to describe labels that included the cartoon character, compared with those that did not.

CONCLUSIONS AND IMPLICATIONS

Results showed that the inclusion of cartoon characters on food labels is associated with fun. Low-income children seem more susceptible to the marketing strategies of food companies than do middle- and high-income children.

Motives Underlying Food Choice for Children and Perception of Nutritional Information Among Low-Income Mothers in a Latin American Country

OBJECTIVE

The aim of the present study was to investigate the influence of nutritional information on how low-income mothers select food for their children.

DESIGN

Five focus groups, each consisting of 5-10 participants, were conducted.

PARTICIPANTS

Women, older than 18 years, mothers of young children who were beneficiaries of one of the national food stamps programs in Uruguay.

PHENOMENON OF INTEREST

Focus group discussions were held around motives underlying food choices for children and perception of labeling systems.

ANALYSIS

Transcripts of the focus group discussions were analyzed using inductive coding.

RESULTS

Forty-two women, aged between 18 and 40 years, participated in 5 focus groups. Results showed that low-income mothers do not consider nutritional information when selecting food their children. Traditional nutritional labeling was perceived as complex, difficult to find, and difficult to understand. Participants stressed that they relied on the nutrition claims included on labels for assessing the healthfulness of food products. Semi-directive and directive front-of-pack labels were positively evaluated in terms of ease of interpretation. Participants preferred the traffic light system over other alternatives.

CONCLUSIONS AND IMPLICATIONS

Results suggest the need to implement simplified nutritional labeling and to regulate the use of nutrition claims on products targeted at children.

Small prizes increased healthful school lunch selection in a Midwestern school district

As obesity has become a pressing health issue for American children, greater attention has been focused on how schools can be used to improve how students eat. Previously, we piloted the use of small prizes in an elementary school cafeteria to improve healthful food selection. We hoped to increase healthful food selection in all the elementary schools of a small school district participating in the United States Department of Agriculture Lunch Program by offering prizes to children who selected a Power Plate (PP), which consisted of an entrée with whole grains, a fruit, a vegetable, and plain low-fat milk. In this study, the PP program was introduced to 3 schools sequentially over an academic year. During the kickoff week, green, smiley-faced emoticons were placed by preferred foods, and children were given a prize daily if they chose a PP on that day. After the first week, students were given a sticker or temporary tattoo 2 days a week if they selected a PP. Combining data from the 3 schools in the program, students increased PP selection from 4.5% at baseline to 49.4% (p < 0.0001) during an intervention period of 2.5 school weeks. The school with the longest intervention period, 6 months, showed a PP selection increase of from 3.9% to 26.4% (p < 0.0001). In conclusion, giving small prizes as rewards dramatically improves short-term healthful food selection in elementary school children.