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Briazu RA, Masood F, Hunt L, Pettinger C, Wagstaff C, McCloy R. Barriers and facilitators to healthy eating in disadvantaged adults living in the UK: a scoping review. BMC Public Health 2024; 24:1770. [PMID: 38961413 PMCID: PMC11221142 DOI: 10.1186/s12889-024-19259-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
In the UK people living in disadvantaged communities are less likely than those with higher socio-economic status to have a healthy diet. To address this inequality, it is crucial scientists, practitioners and policy makers understand the factors that hinder and assist healthy food choice in these individuals. In this scoping review, we aimed to identify barriers and facilitators to healthy eating among disadvantaged individuals living in the UK. Additionally, we used the Theoretical Domains Framework (TDF) to synthesise results and provide a guide for the development of theory-informed behaviour change interventions. Five databases were searched, (CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science) for articles assessing healthy dietary intake of disadvantaged adults living in the UK. A total of 50 papers (34 quantitative; 16 qualitative) were included in this review. Across all studies we identified 78 barriers and 49 facilitators found to either impede and/or encourage healthy eating. Both barriers and facilitators were more commonly classified under the Environmental, Context and Resources TDF domain, with 74% of studies assessing at least one factor pertaining to this domain. Results thus indicate that context related factors such as high cost and accessibility of healthy food, rather than personal factors, such as lack of efficiency in healthy lifestyle drive unhealthy eating in disadvantaged individuals in the UK. We discuss how such factors are largely overlooked in current interventions and propose that more effort should be directed towards implementing interventions that specifically target infrastructures rather than individuals.
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Affiliation(s)
- Raluca A Briazu
- School of Psychology and Clinical Language Sciences, University of Reading, Berkshire, UK
| | - Fatima Masood
- School of Psychology and Clinical Language Sciences, University of Reading, Berkshire, UK
| | - Louise Hunt
- Faculty of Health, University of Plymouth, Plymouth, UK
| | | | - Carol Wagstaff
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Rachel McCloy
- School of Psychology and Clinical Language Sciences, University of Reading, Berkshire, UK.
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2
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Ma Z. "I Can See a Story from the Warning": Understanding the Role of Perceived Narrativity in Pictorial Warning Labels. HEALTH COMMUNICATION 2024; 39:675-684. [PMID: 36803193 DOI: 10.1080/10410236.2023.2181050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This study examined the role of perceived narrativity in pictorial warning labels (PWLs) in countering warning reactance and increasing warning effectiveness and support in the context of communicating the cancer risk of alcohol. Findings from a randomized experiment (N = 1,188) showed that PWLs with imagery of lived experience were perceived higher in narrativity than those with imagery of graphic health effects. Adding a one-sentence narrative (vs. non-narrative) text statement to PWLs with imagery of lived experience did not affect perceived narrativity. Perceived narrativity predicted lower reactance to warnings and subsequently higher intentions to stop drinking and higher policy support. Total effects showed that PWLs with imagery of lived experience and non-narrative text led to the lowest reactance, the highest intentions to stop drinking, and the highest level of policy support. This study adds to a growing body of evidence that PWLs featuring narrative content are promising in communicating health risks.
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Affiliation(s)
- Zexin Ma
- Department of Communication, Journalism, and Public Relations, Oakland University
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3
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Toumpakari Z, Valerino-Perea S, Willis K, Adams J, White M, Vasiljevic M, Ternent L, Brown J, Kelly MP, Bonell C, Cummins S, Majeed A, Anderson S, Robinson T, Araujo-Soares V, Watson J, Soulsby I, Green D, Sniehotta FF, Jago R. Exploring views of members of the public and policymakers on the acceptability of population level dietary and active-travel policies: a qualitative study. Int J Behav Nutr Phys Act 2023; 20:64. [PMID: 37259093 DOI: 10.1186/s12966-023-01465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/06/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND There is limited evidence on what shapes the acceptability of population level dietary and active-travel policies in England. This information would be useful in the decision-making process about which policies should be implemented and how to increase their effectiveness and sustainability. To fill this gap, we explored public and policymakers' views about factors that influence public acceptability of dietary and active-travel policies and how to increase public acceptability for these policies. METHODS We conducted online, semi-structured interviews with 20 members of the public and 20 policymakers in England. A purposive sampling frame was used to recruit members of the public via a recruitment agency, based on age, sex, socioeconomic status and ethnicity. Policymakers were recruited from existing contacts within our research collaborations and via snowball sampling. We explored different dietary and active-travel policies that varied in their scope and focus. Interviews were transcribed verbatim and analysed using thematic reflexive analysis with both inductive and deductive coding. RESULTS We identified four themes that informed public acceptability of dietary and active-travel policies: (1) perceived policy effectiveness, i.e., policies that included believable mechanisms of action, addressed valued co-benefits and barriers to engage in the behaviour; (2) perceived policy fairness, i.e., policies that provided everyone with an opportunity to benefit (mentioned only by the public), equally considered the needs of various population subgroups and rewarded 'healthy' behaviours rather than only penalising 'unhealthy' behaviours; (3) communication of policies, i.e., policies that were visible and had consistent and positive messages from the media (mentioned only by policymakers) and (4) how to improve policy support, with the main suggestion being an integrated strategy addressing multiple aspects of these behaviours, inclusive policies that consider everyone's needs and use of appropriate channels and messages in policy communication. CONCLUSIONS Our findings highlight that members' of the public and policymakers' support for dietary and active-travel policies can be shaped by the perceived effectiveness, fairness and communication of policies and provide suggestions on how to improve policy support. This information can inform the design of acceptable policies but can also be used to help communicate existing and future policies to maximise their adoption and sustainability.
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Affiliation(s)
- Z Toumpakari
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - S Valerino-Perea
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - K Willis
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - J Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - M White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - M Vasiljevic
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Department of Psychology, Durham University, Durham, UK
| | - L Ternent
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - J Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - M P Kelly
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - C Bonell
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - S Cummins
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - A Majeed
- Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
| | - S Anderson
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Department of Psychology, Durham University, Durham, UK
| | - T Robinson
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
- The National Institute for Health Research, Applied Research Collaboration Northeast and North Cumbria (NIHR ARC NENC), St Nicholas' Hospital, Newcastle Upon Tyne, Jubilee Road, Gosforth, NE3 3XT, UK
| | - V Araujo-Soares
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Faculty of Behavioural, Management and Social Sciences, Department of Health Technology and Services Research, University of Twente, Twente, The Netherlands
| | - J Watson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- South Gloucestershire Council, Badminton Road, Yate, Bristol, BS37 5AF, UK
| | - I Soulsby
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
| | - D Green
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - F F Sniehotta
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
- Department for Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - R Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Applied Research Collaboration West (NIHR ARC West), The National Institute for Health Research, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK
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Roque L, Campos L, Guedes D, Godinho C, Truninger M, Graça J. Insights into parents' and teachers' support for policies promoting increased plant-based eating in schools. Appetite 2023; 184:106511. [PMID: 36858261 DOI: 10.1016/j.appet.2023.106511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/24/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023]
Abstract
Global environmental and public health challenges related to current food systems call for large-scale shifts towards increasingly plant-based diets, especially in Western meat-centric societies. School meal systems can play a role in these changes due to their widespread prevalence and multi-sectoral impact. However, there is a lack of evidence about how adults involved in the school meals system perceive school-based pro-environmental food policies, which limits the ability to align those policies with the needs and expectations of the school community. This study aimed to address this knowledge gap by exploring parents' (n = 104) and teachers' (n = 252) support for policies to promote increased plant-based eating in public schools in a highly meat-centric EU country (Portugal). Overall, teachers seemed to be slightly more supportive of such policies and displayed more favorable (injunctive and dynamic) norms toward plant-based eating, more negative appraisals of meals with meat (i.e., perceived healthiness, naturalness, and sustainability), and lower attachment to meat consumption. Furthermore, injunctive norms in favor of plant-based meals were linked with higher support for measures promoting plant-based meals in schools, in both samples (parents, teachers). Lower meat attachment and favorable perceived meal attributes (e.g., perceptions about plant-based and fish meals) were associated with teachers' support for measures promoting plant-based meals in schools. These findings suggest that future efforts and research with parents and teachers to enable less meat-centric and more flexitarian food practices in schools should consider social and motivation variables relevant to plant-forward transitions.
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Affiliation(s)
- Lisa Roque
- Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | - Lúcia Campos
- Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal; Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal
| | - David Guedes
- Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal; Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal
| | - Cristina Godinho
- NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Monica Truninger
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal
| | - João Graça
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal; University of Groningen, Groningen, the Netherlands.
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Vesnaver E, Butler-Foster T, Goldman M, Gibson E, Palumbo A, Lapierre D, Hill NE, MacDonagh R, Rubini KA, Bridel W, Miguel G, Rosser A, MacPherson P, Randall T, Osbourne-Sorrell W, O'Brien SF, Otis J, Greaves M, Al-Bakri TB, Germain M, Orvis S, Clapperton AT, Reid M, Labrecque M, Devine D, Presseau J. Improved access yet inequitable experience: gay, bisexual and other men who have sex with men's views of more inclusive criteria for source plasma donation. BMC Public Health 2023; 23:768. [PMID: 37098497 PMCID: PMC10131411 DOI: 10.1186/s12889-023-15424-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/11/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Canada has incrementally reduced restrictions to blood and plasma donation that impact men who have sex with men, gay, bisexual, and queer men, and some Two Spirit, transgender and non-binary individuals (MSM/2SGBTQ+). Prior to the launch of a pilot program in 2021 enabling some MSM/2SGBTQ + to donate source plasma, we explored the acceptability of the program among individuals who could become eligible to donate in the program. METHODS We invited men identifying as MSM/2SGBTQ + to participate in two consecutive semi-structured interviews to explore their views on blood and plasma donation policy, plasma donation, and the proposed Canadian plasma donation program. Interview transcripts were analyzed thematically and acceptability-related themes were mapped onto the Theoretical Framework of Acceptability. RESULTS Twenty-seven men identifying as having sex with men participated in 53 interviews. Eighteen themes were mapped onto the seven construct domains of the Theoretical Framework of Acceptability. Underlying all aspects of acceptability was a tension between four primary values influencing participants' views: altruism, equity, supply sufficiency, and evidence-based policy. The program was viewed as welcome progress on a discriminatory policy, with many excited to participate, yet tension with inequitable aspects of the program undermined support for the program and interest to contribute to it. The high demands of the program are unique for MSM/2SGBTQ + and are only tolerable as part of a program that is an incremental and instrumental step to more equitable donation policies. CONCLUSION Findings highlight past experiences of exclusion in Canada as a unique and critical part of the context of the donation experience among MSM/2SGBTQ+. Despite the program's goals of greater inclusivity of MSM/2SGBTQ + individuals, the anticipated experience of the program included continued stigmatization and inequities. Future research should seek to understand the experienced views of MSM/2SGBTQ + donors to ensure that as policies change, policies are implemented equitably.
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Affiliation(s)
- Elisabeth Vesnaver
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, K1H 8M2, Ottawa, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
| | | | - Mindy Goldman
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Canada
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Emily Gibson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, K1H 8M2, Ottawa, Canada
| | - Amelia Palumbo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, K1H 8M2, Ottawa, Canada
| | - Don Lapierre
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Canada
| | - Nolan E Hill
- Centre for Sexuality, Calgary, Canada
- Local Advisory Group, Calgary, Canada
| | | | | | - William Bridel
- Local Advisory Group, Calgary, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | | | - Paul MacPherson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, K1H 8M2, Ottawa, Canada
- Department of Medicine, The Ottawa Hospital, Ottawa, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada
| | | | | | - Sheila F O'Brien
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Canada
| | - Joanne Otis
- Department of Sexology, Université du Québec À Montréal, Montreal, Canada
| | | | | | - Marc Germain
- Medical Affairs, Héma-Québec, Quebec City, Canada
| | | | | | | | | | - Dana Devine
- Canadian Blood Services, Vancouver, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, K1H 8M2, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- School of Psychology, University of Ottawa, Ottawa, Canada
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6
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Pechey R, Reynolds JP, Cook B, Marteau TM, Jebb SA. Acceptability of policies to reduce consumption of red and processed meat: A population-based survey experiment. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2022; 81:101817. [PMID: 36523649 PMCID: PMC9742849 DOI: 10.1016/j.jenvp.2022.101817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 05/15/2023]
Abstract
Policies to reduce meat consumption are needed to help achieve climate change targets, and could also improve population health. Public acceptability can affect the likelihood of policy implementation. This study estimated the acceptability of policies to reduce red and processed meat consumption, and whether acceptability differed when policies were framed as benefitting health or the environment. In an online experiment, 2215 UK adults rated the acceptability of six policies, presented in a randomised order. Prior to rating policies, participants were randomised to one of two framing conditions, with policy outcomes described either as benefitting health or the environment. Regression models examined differences in the primary outcome - policy acceptability (rated on a 7-point scale) - by framing. Labels were the most accepted policy (48% support), followed by a media campaign (45%), reduced availability (40%) and providing incentives (38%). Increasing price (27%) and banning advertising (26%) were the least accepted. A substantial proportion of participants neither supported nor opposed most policies (26-33%), although this fell to 16% for increasing price. There was no evidence that framing policy benefits from a health or environment perspective influenced acceptability (-0.06, 95%CIs: 0.18,0.07). Fewer than half of the UK sample expressed support for any of six policies to reduce meat consumption, regardless of framing measures as benefitting health or the environment. Conversely, fewer than half expressed opposition, with the exception of price, suggesting considerable scope to influence public opinion in support of meat reduction measures to meet environmental and health goals.
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Affiliation(s)
- Rachel Pechey
- University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - James P. Reynolds
- University of Cambridge, Cambridge Institute of Public Health, Forvie Site, Cambridge, CB2 0SR, UK
- School of Psychology, Aston University, Birmingham, B4 7ET, UK
| | - Brian Cook
- University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Theresa M. Marteau
- University of Cambridge, Cambridge Institute of Public Health, Forvie Site, Cambridge, CB2 0SR, UK
| | - Susan A. Jebb
- University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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7
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Mantzari E, Reynolds JP, Jebb SA, Hollands GJ, Pilling MA, Marteau TM. Public support for policies to improve population and planetary health: A population-based online experiment assessing impact of communicating evidence of multiple versus single benefits. Soc Sci Med 2022; 296:114726. [PMID: 35093794 PMCID: PMC8907862 DOI: 10.1016/j.socscimed.2022.114726] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/20/2022]
Abstract
Background Effective interventions for reducing the consumption of products that harm population and planetary health often lack public support, impeding implementation. Communicating evidence of policies’ effectiveness can increase public support but there is uncertainty about the most effective ways of communicating this evidence. Some policies have multiple benefits such as both improving health and the environment. This study assesses whether communicating evidence of multiple versus single benefits of a policy increases its support. Method Participants (n = 4616) nationally representative of the British population were randomised to one of 24 groups in an online experiment with a 4 × 3 × 2 between-subjects factorial design. The messages that participants viewed differed according to the evidence they communicated (no message, effectiveness for changing behaviour, effectiveness for changing behaviour + one policy benefit, effectiveness for changing behaviour + three policy benefits), type of policy (taxation, availability) and the target behaviour (consumption of energy-dense food, alcohol, or meat). The primary outcome was policy support. Results In a full factorial ANOVA, there was a significant main effect of communicating evidence of effectiveness on policy support, which was similar across policies and behaviours. Communicating three benefits increased support relative to communicating one benefit (d = 0.15; p = 0.01). Communicating one benefit increased support compared to providing evidence for changing behaviour alone (d = 0.13; p = 0.004) or no message (d = 0.11 p = 0.022). Conclusion Communicating evidence of a policy's benefits increases support for policy action across different behaviours and policies. Presenting multiple benefits of policies enhances public support. Providing evidence of policies effectiveness at achieving policy goals increases public support. Uncertainty exists about the most effective ways of communicating this evidence. Evidence about multiple policy benefits increases support more than evidence for a single benefit. Effects are evident across behaviours and policies.
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Affiliation(s)
- Eleni Mantzari
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - James P Reynolds
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Mark A Pilling
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
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Williams AJ, Manner J, Nightingale G, Turner K, Kelly P, Baker G, Cleland C, Hunter R, Jepson R. Public attitudes to, and perceived impacts of 20mph (32km/h) speed limits in Edinburgh: an exploratory study using the Speed Limits Perceptions Survey (SLiPS). TRANSPORTATION RESEARCH. PART F, TRAFFIC PSYCHOLOGY AND BEHAVIOUR 2022; 84:99-113. [PMID: 34987309 PMCID: PMC7612163 DOI: 10.1016/j.trf.2021.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 06/14/2023]
Abstract
Between 2016 and 2018 a policy was implemented to increase the proportion of 20mph (32 km/h) streets in Edinburgh, UK from approximately 50% to 80%, providing the opportunity to evaluate how behaviour and public perceptions change over time. This is important as negative public responses have been reported to limit the implementation of transport policies and may reduce the effectiveness of the policy. The Speed Limits Perception Survey (SLiPS) was developed to assess changes in public perceptions from baseline to 6 and 12 months post-implementation. We collected 3,485 individual responses to the survey, 64.6% (n=2,253) of which included complete perceptions data. Using exploratory factor analysis, the following perception factors were identified: i) Detraction and resistance, ii) Support, iii) Rule following, iv) Child safety, and v) Walking safety. Following the 20mph implementation at 6-12 months: Support (ii) and Rule following (iii) had increased; Detraction and resistance (i) had decreased; and Child safety (iv) and Walking safety (v) had not changed significantly. These findings indicate that the public in Edinburgh became more positive towards the policy once it was implemented. However, more extensive policy or ongoing communication of the safety benefits of 20mph limits are needed to increase perceptions of safety that might lead to increased walking and cycling. Future research should aim to understand how those implementing speed limit interventions can positively influence public perceptions and how public perceptions about speed limits influence behaviour.
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Affiliation(s)
- Andrew James Williams
- Population and Behavioural Science, School of Medicine, University of St Andrews, Room 219, Medical and Biological Sciences Building, North Haugh, St Andrews, Fife KY16 9TF, United Kingdom
| | - Jillian Manner
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Science, University of Edinburgh, 5 Forrest Hill, Edinburgh EH1 2QL, United Kingdom
| | - Glenna Nightingale
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Science, University of Edinburgh, 5 Forrest Hill, Edinburgh EH1 2QL, United Kingdom
| | - Kieran Turner
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Science, University of Edinburgh, 5 Forrest Hill, Edinburgh EH1 2QL, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre (PAHRC), Institute for Sport, PE and Health Sciences, University of Edinburgh, Moray House School of Education and Sport, Edinburgh EH8 8AQ, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre (PAHRC), Institute for Sport, PE and Health Sciences, University of Edinburgh, Moray House School of Education and Sport, Edinburgh EH8 8AQ, United Kingdom
| | - Claire Cleland
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Sciences, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
| | - Ruth Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Sciences, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Science, University of Edinburgh, 5 Forrest Hill, Edinburgh EH1 2QL, United Kingdom
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9
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Clarke N, Pechey E, Kosīte D, König LM, Mantzari E, Blackwell AK, Marteau TM, Hollands GJ. Impact of health warning labels on selection and consumption of food and alcohol products: systematic review with meta-analysis. Health Psychol Rev 2021; 15:430-453. [PMID: 32515697 PMCID: PMC8635708 DOI: 10.1080/17437199.2020.1780147] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 06/03/2020] [Indexed: 01/31/2023]
Abstract
Health warning labels (HWLs) could reduce harmful consumption of food (including non-alcoholic drinks) and alcoholic drinks. A systematic review with meta-analysis using Cochrane methods was conducted to assess the impact on selection (including hypothetical selection) or consumption of food or alcoholic drink products displaying image-and-text (sometimes termed 'pictorial') and text-only HWLs. Fourteen randomised controlled trials were included, three for alcohol, eleven for food. For the primary outcomes, eleven studies measured selection and one measured consumption (two measured only other secondary outcomes). Meta-analysis of twelve comparisons from nine studies (n=12,635) found HWLs reduced selection of the targeted product compared with no HWL (RR=0.74 (95%CI 0.68-0.80)), with participants 26% less likely to choose a product displaying a HWL. A planned subgroup analysis suggested a larger (although not statistically significant) effect on selection of image-and-text HWLs (RR=0.65 (95%CI 0.54-0.80)) than text-only HWLs (RR=0.79 (95%CI 0.74-0.85)). These findings suggest significant potential for HWLs to reduce selection of food and alcoholic drinks, but all experimental studies to date were conducted in laboratory or online settings with outcomes assessed immediately after a single exposure. Studies in field and naturalistic laboratory settings are needed to estimate the potential effects of food and alcohol HWLs.Study registration: PROSPERO 2018 (registration number: CRD42018106522).
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Affiliation(s)
- Natasha Clarke
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Emily Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Daina Kosīte
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Laura M. König
- Psychological Assessment & Health Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Eleni Mantzari
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Anna K.M. Blackwell
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Theresa M. Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Gareth J. Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
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Dudás L, Szántó R. Nudging in the time of coronavirus? Comparing public support for soft and hard preventive measures, highlighting the role of risk perception and experience. PLoS One 2021; 16:e0256241. [PMID: 34388215 PMCID: PMC8362989 DOI: 10.1371/journal.pone.0256241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/03/2021] [Indexed: 11/18/2022] Open
Abstract
The importance of researching public support for preventive policies have been amplified by the COVID-19 pandemic. Using a representative sample of the Hungarian population, we investigated the support for commonly used preventive measures (social distancing, hand hygiene and wearing masks) comparing two different policy tools (nudges and regulations). Because of the high risk and unfamiliarity of the pandemic, the respondents' risk perception and experience with the disease was also assessed. All preventive measures were generally supported and, contrary to the findings of previous nudge research, there was no clear pattern whether regulations or nudges are preferred. People with higher level of risk perception supported both types of policies more but slightly favoured the regulations. Those who had contact with the disease (either themselves or a close friend or family member contracting COVID-19) reported a higher level of risk perception. When the person themselves was afflicted, this higher levels of risk perception did not translate to a higher level of support, moreover, it even decreased support for the regulations according to regression analysis. In case of a loved one contracting the disease, there was an increased support for both types of measures, but that is explained by the higher risk perception.
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Affiliation(s)
- Levente Dudás
- Department of Decision Sciences, Corvinus University of Budapest, Budapest, Hungary
| | - Richárd Szántó
- Department of Decision Sciences, Corvinus University of Budapest, Budapest, Hungary
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11
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Robinson E, Smith J, Jones A. The effect of calorie and physical activity equivalent labelling of alcoholic drinks on drinking intentions in participants of higher and lower socioeconomic position: An experimental study. Br J Health Psychol 2021; 27:30-49. [PMID: 33949052 DOI: 10.1111/bjhp.12527] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 04/19/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The primary objective of the study was to examine the effect of calorie labelling and physical activity equivalence labelling of alcoholic drinks on drinking intentions in participants of lower and higher socioeconomic position (SEP). METHODS Participants (N = 1,084) of higher and lower SEP were recruited into an online study and randomized into one of three drink label conditions; Control (standard alcohol labelling), kcal labelling (standard labelling plus drink kilocalorie information), or kcal + PACE labelling (standard labelling and kilocalorie information, plus information on physical activity needed to compensate for drink calories). After viewing drink labels, participants reported alcohol drinking intentions. Participants also completed measures of alcoholic drink energy content estimation, beliefs about how calorie labelling would affect health behaviour and support for calorie labelling of alcoholic drinks. RESULTS kcal labelling (d = 0.31) and kcal + PACE labelling (d = 0.38) conditions had significantly lower drinking intentions compared to the control condition (ps < .001). There was no evidence that effect of labelling condition on drinking intentions was moderated by SEP. A subset of participants also reported that they believed calorie labelling would be likely to positively change their eating and exercise behaviour. Estimates of the energy content of alcoholic drinks tended to be inaccurate and the majority of participants supported the introduction of calorie labelling on alcoholic drinks. CONCLUSIONS Calorie labelling of alcoholic drinks resulted in small reductions to intended drinking and testing of the effect calorie labelling has on behaviour in real-world settings is now warranted.
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Affiliation(s)
- Eric Robinson
- Department of Psychology, University of Liverpool, UK
| | - Jemma Smith
- Department of Psychology, University of Liverpool, UK
| | - Andrew Jones
- Department of Psychology, University of Liverpool, UK
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12
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Lee JGL, Cristello JV, Buckton CH, Carey RN, Trucco EM, Schenk PM, Ikegwuonu T, Hilton S, Golden SD, Conway DI. Message framing to inform cancer prevention pricing interventions in the UK and USA: a factorial experiment, 2019. BMJ Open 2021; 11:e041324. [PMID: 33495253 PMCID: PMC7839858 DOI: 10.1136/bmjopen-2020-041324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/10/2020] [Accepted: 12/18/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To advance understanding of how message framing can be used to maximise public support across different pricing policies for alcohol, tobacco and sugary drinks/foods that prevent consumption of cancer-causing products. DESIGN We designed a 3×4×3 randomised factorial experiment to test responses to messages with three pricing policies, four message frames and three products. SETTING Online survey panel (Qualtrics) in 2019. PARTICIPANTS Adults (N=1850) from the UK and USA. INTERVENTIONS Participants randomly viewed one of 36 separate messages that varied by pricing policy (increasing taxes, getting rid of price discounts, getting rid of low-cost products), four frames and product (alcohol, tobacco, sugary drinks/foods). PRIMARY AND SECONDARY OUTCOME MEASURES We assessed the relationship between the message characteristics and four dependent variables. Three were related to policy support: (1) increasing taxes on the product mentioned in the message, (2) getting rid of price discounts and special offers on the product mentioned in the message and (3) getting rid of low-cost versions of the product mentioned in the message. One was related to reactance, a psychological response to having one's freedom limited. RESULTS We found no effect for pricing policy in the message. Frames regarding children and reducing cancer risk moderated some outcomes, showing promise for real-world use. We found differences in support by product and reactance with greatest support and least reactance for tobacco policies, less support and more reactance for alcohol policies, and the least support and most reactance for sugary drinks/foods policies. CONCLUSIONS Cancer prevention efforts using policy interventions can be informed by the message framing literature. Our results offer insights for cancer prevention advocacy efforts across the UK and USA and highlight that tax versus non-tax approaches to increasing the cost of cancer-causing products result in similar responses from consumers.
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Affiliation(s)
- Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Julie V Cristello
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Christina H Buckton
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Rachel N Carey
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Elisa M Trucco
- Department of Psychology and Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Paulina M Schenk
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Theresa Ikegwuonu
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Shelley D Golden
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David I Conway
- School of Medicine, Dentistry, and Nursing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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13
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Clarke N, Pechey E, Mantzari E, Blackwell AKM, De-Loyde K, Morris RW, Munafò MR, Marteau TM, Hollands GJ. Impact of health warning labels communicating the risk of cancer on alcohol selection: an online experimental study. Addiction 2021; 116:41-52. [PMID: 32267588 DOI: 10.1111/add.15072] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/25/2019] [Accepted: 04/01/2020] [Indexed: 01/08/2023]
Abstract
AIMS Evidence from tobacco research suggests that health warning labels (HWLs) depicting the adverse consequences of consumption change smoking behaviours, with image-and-text (also known as 'pictorial' or 'graphic') HWLs most effective. There is an absence of evidence concerning the potential impact of HWLs placed on alcohol products on selection of those products. This study aimed to obtain a preliminary assessment of the possible impact of (i) image-and-text, (ii) text-only, and (iii) image-only HWLs on selection of alcoholic versus non-alcoholic drinks. DESIGN A between-subjects randomised experiment with a 2 (image: present versus absent) × 2 (text: present versus absent) factorial design. SETTING The study was conducted on the online survey platform Qualtrics. PARTICIPANTS Participants (n = 6024) were adults over the age of 18 who consumed beer or wine regularly (i.e. at least once a week), recruited through a market research agency. INTERVENTIONS Participants were randomised to one of four groups varying in the HWL displayed on the packaging of alcoholic drinks: (i) image-and-text HWL; (ii) text-only HWL; (iii) image-only HWL; and (iv) no HWL. HWLs depicted bowel cancer, breast cancer and liver cancer, which were each displayed twice across six alcoholic drinks. Each group viewed six alcoholic and six non-alcoholic drinks and selected one drink that they would like to consume. MEASUREMENTS The primary outcome was the proportion of participants selecting an alcoholic versus a non-alcoholic drink. FINDINGS Alcoholic drink selection was lower for all HWL types compared with no HWL (image-and-text: 56%; image-only: 49%; text-only: 61%; no HWL: 77%), with selection lowest for HWLs that included an image. Image-and-text HWLs reduced the odds of selecting an alcoholic drink compared with text-only HWLs (OR = 0.80, 95% CI = 0.69, 0.92), but increased the odds of selecting an alcoholic drink compared with image-only HWLs (OR = 1.34, 95% CI = 1.16, 1.55). CONCLUSIONS Health warning labels communicating the increased risk of cancers associated with alcohol consumption reduced selection of alcoholic versus non-alcoholic drinks in a hypothetical choice task in an online setting; labels displaying images had the largest effect. Their impact in laboratory and real-world field settings using physical products awaits investigation.
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Affiliation(s)
- Natasha Clarke
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Emily Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Eleni Mantzari
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Anna K M Blackwell
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Katie De-Loyde
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | | | - Marcus R Munafò
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
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14
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Clarke N, Pechey E, Mantzari E, Blackwell AKM, De-Loyde K, Morris RW, Munafò MR, Marteau TM, Hollands GJ. Impact of health warning labels on snack selection: An online experimental study. Appetite 2020; 154:104744. [PMID: 32562806 PMCID: PMC7450271 DOI: 10.1016/j.appet.2020.104744] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 11/30/2022]
Abstract
Excessive consumption of energy-dense food increases the risk of obesity, which in turn increases the risk of non-communicable diseases, including heart disease, type 2 diabetes and most non-smoking-related cancers. Health warning labels (HWLs) that communicate the adverse health consequences of excess energy consumption could reduce intake of energy-dense foods. The aim of the current study was to estimate the impact on selection of energy-dense snacks of (a) image-and-text HWLs (b) text-only HWLs and (c) calorie information. In a between-subjects, 3 (HWL: image-and-text, text-only, no label) x 2 (calorie information: present, absent), factorial experimental design, participants (N = 4134) were randomised to view a selection of energy-dense and non-energy-dense snacks with one of five label types or no label. The primary outcome was the proportion of participants selecting an energy-dense snack in a hypothetical vending machine task. The proportion of participants selecting an energy-dense snack was reduced in all label groups, relative to the no label group (no label: 59%; calories only: 54%; text-only HWL: 48%; text-only HWL with calories: 44%; image-and-text HWL: 37%; image-and-text HWL with calories: 38%). Compared to the no label group, participants were least likely to select an energy-dense snack in the image-and-text HWL group (OR = 0.46, 95%CI = 0.40, 0.54, p < 0.001). Health warning labels - particularly those including an image and text - have the potential to reduce selection of energy-dense snacks in an online setting. Their impact on selection and consumption in real-world settings awaits testing.
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Affiliation(s)
- Natasha Clarke
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
| | - Emily Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Eleni Mantzari
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Anna K M Blackwell
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Katie De-Loyde
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | | | - Marcus R Munafò
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
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15
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Reynolds JP, Vasiljevic M, Pilling M, Marteau TM. Communicating evidence about the environment's role in obesity and support for government policies to tackle obesity: a systematic review with meta-analysis. Health Psychol Rev 2020; 16:67-80. [PMID: 33003986 PMCID: PMC8884254 DOI: 10.1080/17437199.2020.1829980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Public support for many policies that tackle obesity by changing environments is low. This may reflect commonly held causal beliefs about obesity, namely that it is due to failures of self-control rather than environmental influences. Several studies have sought to increase public support by changing these and similar causal beliefs, with mixed results. The current review is the first systematic synthesis of these studies. Searches of PsycInfo, Medline, Web of Science, Scopus, and Open Grey yielded 20 eligible studies (N = 8977) from 11,776 abstracts. Eligible studies were controlled experiments with an intervention group that communicated information about the environment’s role in obesity, and a measure of support for environment-based obesity policies. The protocol was prospectively registered on PROSPERO. Meta-analyses showed no evidence that communicating information about the environment’s influence on obesity changed policy support or the belief that the environment influences obesity. A likely explanation for this null effect is the ineffectiveness of interventions that were designed to change the belief that the environment influences obesity. The possibility remains, however, that the association observed between beliefs about the causes of obesity and attitudes towards obesity policies is correlational and not causal.
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Affiliation(s)
- James P Reynolds
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Milica Vasiljevic
- Department of Psychology, Upper Mountjoy, Durham University, Durham, UK
| | - Mark Pilling
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
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16
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Reynolds JP, Vasiljevic M, Pilling M, Hall MG, Ribisl KM, Marteau TM. Communicating Evidence about the Causes of Obesity and Support for Obesity Policies: Two Population-Based Survey Experiments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186539. [PMID: 32911776 PMCID: PMC7559841 DOI: 10.3390/ijerph17186539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 02/01/2023]
Abstract
Public support for numerous obesity policies is low, which is one barrier to their implementation. One reason for this low support is the tendency to ascribe obesity to failings of willpower as opposed to the environment. Correlational evidence supports this position. However, the experimental evidence is mixed. In two experimental studies, participants were randomised to receive no message, messages about the environment's influence on obesity (Study 1 & 2), or messages about the environment's influence on human behaviour (Study 1). We investigated whether communicating these messages changed support for obesity policies and beliefs about the causes of obesity. Participants were recruited from nationally representative samples in Great Britain (Study 1 & 2) and the USA (Study 2) (total n = 4391). Study 2 was designed to replicate existing research. Neither study found evidence that communicating the messages increased support for obesity policies or strengthened beliefs about the environment's role in obesity. Study 2, therefore, did not replicate two earlier experimental studies. Instead, the studies reported here suggest that people's beliefs about the causes of obesity are resistant to change in response to evidence and are, therefore, not a promising avenue to increase support for obesity policies.
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Affiliation(s)
- James P. Reynolds
- Behaviour and Health Research Unit, University of Cambridge, Cambridge CB2 0SR, UK; (M.V.); (M.P.)
- Correspondence: (J.P.R.); (T.M.M.)
| | - Milica Vasiljevic
- Behaviour and Health Research Unit, University of Cambridge, Cambridge CB2 0SR, UK; (M.V.); (M.P.)
- Department of Psychology, Durham University, Durham DH1 3LE, UK
| | - Mark Pilling
- Behaviour and Health Research Unit, University of Cambridge, Cambridge CB2 0SR, UK; (M.V.); (M.P.)
| | - Marissa G. Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; (M.G.H.); (K.M.R.)
- Department of Health Behaviour, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 275599, USA
| | - Kurt M. Ribisl
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; (M.G.H.); (K.M.R.)
- Department of Health Behaviour, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 275599, USA
| | - Theresa M. Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge CB2 0SR, UK; (M.V.); (M.P.)
- Correspondence: (J.P.R.); (T.M.M.)
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17
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Bullivant B, Mitchison D, Skromanis S, Mond J. Elucidating individuals' beliefs about the severity of eating disorders and obesity: implications for public health programs. Eat Weight Disord 2020; 25:929-938. [PMID: 31098985 DOI: 10.1007/s40519-019-00708-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 05/02/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To examine perceptions of the severity of eating disorders and obesity and the effects on these of an information manipulation while also considering the influence of potential covariates such as age, gender, physical and mental health and beliefs about the prevalence and causes of the respective conditions. METHODS Australian women and men (n = 488) aged 18-73 years were randomly assigned to one of four conditions: no information, neutral information, eating disorders emphasis and obesity emphasis. Mixed-model analysis of variance (ANOVA) was used to compare the perceived severity of eating disorders and obesity (within-subjects factor), while also testing the effect of manipulating information, i.e., selectively emphasising the occurrence and adverse effects of one condition or the other (between-subjects factor), on perceptions of severity. Correlational analysis was used to examine associations between perceptions of severity and potential covariates, those covariates for which significant associations were observed being included as covariates in the ANOVA. RESULTS Eating disorders were perceived to be a more severe condition than obesity and the information manipulation was largely ineffective. Perceptions of the severity of both eating disorders and obesity were found to be associated with several covariates, including gender, body dissatisfaction, familiarity with and beliefs about the prevalence of eating disorders and beliefs about the causes of both eating disorders and obesity. CONCLUSIONS The findings support the need for-and provide a platform for-greater collaboration between obesity and eating disorder researchers in the development of integrated prevention and health promotion programs. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Bianca Bullivant
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Macquarie University, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Skromanis
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia
| | - Jonathan Mond
- School of Medicine, Western Sydney University, Sydney, Australia.
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia.
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18
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Sharp CA, Bellis MA, Hughes K, Ford K, Di Lemma LCG. Public acceptability of public health policy to improve population health: A population-based survey. Health Expect 2020; 23:802-812. [PMID: 32329938 PMCID: PMC7495082 DOI: 10.1111/hex.13041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND For public health policies to be effective, it is critical that they are acceptable to the public as acceptance levels impact success rate. OBJECTIVE To explore public acceptance of public health statements and examine differences in acceptability across socio-demographics, health behaviours (physical activity, diet, binge drinking and smoking), health status and well-being. METHOD A cross-sectional survey was conducted with a nationally representative sample (N = 1001) using a random stratified sampling method. Face-to-face interviews were conducted at homes of residents in Wales aged 16+ years. Individuals reported whether they agreed, had no opinion, or disagreed with 12 public health statements. RESULTS More than half of the sample were supportive of 10 out of 12 statements. The three statements with the greatest support (>80% agreement) reflected the importance of: a safe and loving childhood to becoming a healthy adult, schools teaching about health, and healthier foods costing less. Individuals who engaged in unhealthy behaviours were less likely to agree with some of the statements (eg 39.8% of binge drinkers agreed alcohol adverts should be banned compared to 57.6% of those who never binge drink; P < .001). CONCLUSIONS Findings show an appetite for public health policies among the majority of the public. The relationship between supporting policies and engaging in healthy behaviours suggests a feedback loop that is potentially capable of shifting both public opinion and the opportunities for policy intervention. If a nation becomes healthier, this could illicit greater support for stronger policies which could encourage more people to move in a healthier direction.
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Affiliation(s)
- Catherine A. Sharp
- Public Health Collaborating UnitSchool of Health SciencesBangor UniversityWrexhamUK
| | - Mark A. Bellis
- Public Health Collaborating UnitSchool of Health SciencesBangor UniversityWrexhamUK
- Policy and International Health DirectorateWorld Health Organization Collaborating Centre on Investment for Health and Well‐beingPublic Health WalesWrexhamUK
| | - Karen Hughes
- Public Health Collaborating UnitSchool of Health SciencesBangor UniversityWrexhamUK
- Policy and International Health DirectorateWorld Health Organization Collaborating Centre on Investment for Health and Well‐beingPublic Health WalesWrexhamUK
| | - Kat Ford
- Public Health Collaborating UnitSchool of Health SciencesBangor UniversityWrexhamUK
| | - Lisa C. G. Di Lemma
- Policy and International Health DirectorateWorld Health Organization Collaborating Centre on Investment for Health and Well‐beingPublic Health WalesWrexhamUK
- Faculty of Health and Social CareUniversity of ChesterChesterUK
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19
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Pechey E, Clarke N, Mantzari E, Blackwell AKM, De-Loyde K, Morris RW, Marteau TM, Hollands GJ. Image-and-text health warning labels on alcohol and food: potential effectiveness and acceptability. BMC Public Health 2020; 20:376. [PMID: 32238154 PMCID: PMC7114781 DOI: 10.1186/s12889-020-8403-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/24/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Health warning labels (HWLs) using images and text to depict the negative health consequences of tobacco consumption are effective and acceptable for changing smoking-related outcomes. There is currently limited evidence concerning their potential use for reducing consumption of alcoholic drinks and energy-dense foods. The aim of this research was to describe the potential effectiveness and acceptability of image-and-text (also known as pictorial or graphic) HWLs applied to: i. alcoholic drinks and ii. energy-dense snack foods. METHODS Two online studies were conducted using between-subjects designs with general population samples. Participants rated one of 21 image-and-text HWLs on alcoholic drinks (n = 5528), or one of 18 image-and-text HWLs on energy-dense snacks (n = 4618). HWLs comprised a graphic image with explanatory text, depicting, respectively, seven diseases linked to excess alcohol consumption, and six diseases linked to excess energy intake. Diseases included heart disease and various cancers. Outcomes were negative emotional arousal, desire to consume the labelled product, and acceptability of the label. Free-text comments relating to HWLs were content analysed. RESULTS For both alcoholic drinks and energy-dense snacks, HWLs depicting bowel cancer generated the highest levels of negative emotional arousal and lowest desire to consume the product, but were the least acceptable. Acceptability was generally low for HWLs applied to alcohol, with 3 of 21 rated as acceptable, and was generally high for snacks, with 13 of 18 rated as acceptable. The majority of free-text comments expressed negative reactions to HWLs on alcohol or energy-dense snacks. CONCLUSIONS Image-and-text health warning labels depicting bowel cancer showed greatest potential for reducing selection and consumption of alcoholic drinks and energy-dense snacks, although they were the least acceptable. Laboratory and field studies are needed to assess their impact on selection and consumption.
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Affiliation(s)
- Emily Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK
| | - Natasha Clarke
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK
| | - Eleni Mantzari
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK
| | - Anna K M Blackwell
- Tobacco and Alcohol Research Group, University of Bristol, School of Psychological Science, Bristol, BS8 1TU, UK
| | - Katie De-Loyde
- Tobacco and Alcohol Research Group, University of Bristol, School of Psychological Science, Bristol, BS8 1TU, UK
| | - Richard W Morris
- Bristol Medical School: Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK.
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20
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Reynolds JP, Stautz K, Pilling M, van der Linden S, Marteau TM. Communicating the effectiveness and ineffectiveness of government policies and their impact on public support: a systematic review with meta-analysis. ROYAL SOCIETY OPEN SCIENCE 2020; 7:190522. [PMID: 32218927 PMCID: PMC7029938 DOI: 10.1098/rsos.190522] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 11/13/2019] [Indexed: 05/27/2023]
Abstract
Low public support for government interventions in health, environment and other policy domains can be a barrier to implementation. Communicating evidence of policy effectiveness has been used to influence attitudes towards policies, with mixed results. This review provides the first systematic synthesis of such studies. Eligible studies were randomized controlled experiments that included an intervention group that provided evidence of a policy's effectiveness or ineffectiveness at achieving a salient outcome, and measured policy support. From 6498 abstracts examined, there were 45 effect sizes from 36 eligible studies. In total, 35 (N = 30 858) communicated evidence of effectiveness, and 10 (N = 5078) communicated evidence of ineffectiveness. Random effects meta-analysis revealed that communicating evidence of a policy's effectiveness increased support for the policy (SMD = 0.11, 95% CI [0.07, 0.15], p < 0.0001), equivalent to support increasing from 50% to 54% (95% CI [53%, 56%]). Communicating evidence of ineffectiveness decreased policy support (SMD = -0.14, 95% CI [-0.22, -0.06], p < 0.001), equivalent to support decreasing from 50% to 44% (95% CI [41%, 47%]). These findings suggest that public support for policies in a range of domains is sensitive to evidence of their effectiveness, as well as their ineffectiveness.
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Affiliation(s)
- J. P. Reynolds
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - K. Stautz
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - M. Pilling
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | | | - T. M. Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
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21
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Walker LA, Chambers CD, Veling H, Lawrence NS. Cognitive and environmental interventions to encourage healthy eating: evidence-based recommendations for public health policy. ROYAL SOCIETY OPEN SCIENCE 2019; 6:190624. [PMID: 31824693 PMCID: PMC6837205 DOI: 10.1098/rsos.190624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/24/2019] [Indexed: 06/10/2023]
Abstract
Policymakers are focused on reducing the public health burden of obesity. The UK average percentage of adults classified as obese is 26%, which is double that of the global average. Over a third of UK adults report using at least one weight management aid. Yet, many people still struggle to change their diet-related behaviour, despite having the awareness, intention and capability to do so. This 'intention-behaviour gap' may be because most existing dietary-choice interventions focus on individual decision-making, ignoring the effects of environmental cues on human behaviour. Behaviour change interventions that 'nudge' people into making healthier choices by modifying the food environment have been shown to be effective. However, this type of intervention is typically challenging for policymakers to implement for economic, ethical and public accessibility reasons. To overcome these concerns, policymakers should consider 'boosting' interventions. Boosting involves enhancing competences that help people make decisions consistent with their goals. Here, we outline cognitive training as a boosting intervention to tackle obesity. We synthesize the evidence for one type of cognitive training (go/no-go training) that may be effective at modifying food-related decisions and reducing body weight. We offer evidence-based recommendations for an obesity-focused Public Health Wales behaviour change programme.
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Affiliation(s)
- Lindsay A. Walker
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Christopher D. Chambers
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Harm Veling
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Reynolds JP, Archer S, Pilling M, Kenny M, Hollands GJ, Marteau TM. Public acceptability of nudging and taxing to reduce consumption of alcohol, tobacco, and food: A population-based survey experiment. Soc Sci Med 2019; 236:112395. [PMID: 31326778 PMCID: PMC6695289 DOI: 10.1016/j.socscimed.2019.112395] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/14/2019] [Accepted: 07/01/2019] [Indexed: 02/07/2023]
Abstract
There is growing evidence for the effectiveness of choice architecture or 'nudge' interventions to change a range of behaviours including the consumption of alcohol, tobacco and food. Public acceptability is key to implementing these and other interventions. However, few studies have assessed public acceptability of these interventions, including the extent to which acceptability varies with the type of intervention, the target behaviour and with evidence of intervention effectiveness. These were assessed in an online study using a between-participants full factorial design with three factors: Policy (availability vs size vs labelling vs tax) x Behaviour (alcohol consumption vs tobacco use vs high-calorie snack food consumption) x Evidence communication (no message vs assertion of policy effectiveness vs assertion and quantification of policy effectiveness [e.g., a 10% change in behaviour]). Participants (N = 7058) were randomly allocated to one of the 36 groups. The primary outcome was acceptability of the policy. Acceptability differed across policy, behaviour and evidence communication (all ps < .001). Labelling was the most acceptable policy (supported by 78%) and Availability the least (47%). Tobacco use was the most acceptable behaviour to be targeted by policies (73%) compared with policies targeting Alcohol (55%) and Food (54%). Relative to the control group (60%), asserting evidence of effectiveness increased acceptability (63%); adding a quantification to this assertion did not significantly increase this further (65%). Public acceptability for nudges and taxes to improve population health varies with the behaviour targeted and the type of intervention but is generally favourable. Communicating that these policies are effective can increase support by a small but significant amount, suggesting that highlighting effectiveness could contribute to mobilising public demand for policies. While uncertainty remains about the strength of public support needed, this may help overcome political inertia and enable action on behaviours that damage population and planetary health.
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Marteau TM, White M, Rutter H, Petticrew M, Mytton OT, McGowan JG, Aldridge RW. Increasing healthy life expectancy equitably in England by 5 years by 2035: could it be achieved? Lancet 2019; 393:2571-2573. [PMID: 31258113 DOI: 10.1016/s0140-6736(19)31510-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/11/2019] [Indexed: 11/23/2022]
Affiliation(s)
- Theresa M Marteau
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Mark Petticrew
- Department of Social and Environmental Research, London School of Hygiene & Tropical Medicine, London UK
| | - Oliver T Mytton
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - James G McGowan
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK
| | - Robert W Aldridge
- Institute of Health Informatics, University College London, London, UK
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Miller CL, Dono J, Wakefield MA, Pettigrew S, Coveney J, Roder D, Durkin SJ, Wittert G, Martin J, Ettridge KA. Are Australians ready for warning labels, marketing bans and sugary drink taxes? Two cross-sectional surveys measuring support for policy responses to sugar-sweetened beverages. BMJ Open 2019; 9:e027962. [PMID: 31248926 PMCID: PMC6597645 DOI: 10.1136/bmjopen-2018-027962] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption. DESIGN A 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2). PARTICIPANTS Study 1: South Australians, 15+ years (n=2732); study 2: Australians, 18+ years (n=3430). PRIMARY OUTCOME MEASURES levels of support for SSB-specific policy initiatives. For the 2017 national study (study 2), demographic characteristics, body mass index, knowledge of potential harms caused by consuming SSBs and SSB consumption were included in multivariable regression analyses. RESULTS In 2017, all 10 potential policy initiatives received majority support (60%-88% either 'somewhat' or 'strongly' in favour). Initiatives with educative elements or focused on children received high support (>70%), with highest support observed for text warning labels on drink containers (88%) and government campaigns warning of adverse health effects (87%). Higher support was observed for SSB tax paired with using funds for obesity prevention (77%) than a stand-alone tax (60%). Support for policy initiatives was generally greater among those who believed SSB daily consumption could cause health problems in adults (4%-18% absolute difference) and/or in children (8%-26% absolute difference) and lower among SSB high consumers (7+ drinks per week; 9%-29% absolute difference). State-specific data comparison indicated increased support from 2014 to 2017 for taxation (42%vs55%; χ2=15.7, p<0.001) and graphic health warnings (52%vs68%; χ2=23.4. p<0.001). CONCLUSIONS There is strong public support for government action, particularly regulatory and educational interventions, to reduce SSB consumption, which appears to have increased since 2014. The findings suggest that framing policies as protecting children, presenting taxation of SSBs in conjunction with other obesity prevention initiatives and education focused on the harms associated with SSB consumption will increase support.
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Affiliation(s)
- Caroline L Miller
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Joanne Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simone Pettigrew
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - David Roder
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, South Australia, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Gary Wittert
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- Centre for Nutrition and GI Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Jane Martin
- Obesity Policy Coalition and Alcohol and Obesity Policy, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerry A Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
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Joslyn MR, Haider-Markel DP. Perceived causes of obesity, emotions, and attitudes about Discrimination Policy. Soc Sci Med 2019; 223:97-103. [PMID: 30718009 DOI: 10.1016/j.socscimed.2019.01.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 12/13/2018] [Accepted: 01/12/2019] [Indexed: 01/09/2023]
Abstract
RATIONALE Although obesity represents a potential public health crisis, our understanding of public perceptions of obesity, emotional responses to the obese, and related policy preferences is limited. OBJECTIVE We employed Weiner's attribution theory of controllability (Weiner, 1988, 2011) to examine perceived causes of obesity, emotional responses, and related policy implications. If the perceived cause is controllable (eating and lifestyle habits), we expected less sympathy and greater anger toward obese people and support for prejudicial hiring policies based on weight. If the cause is perceived as uncontrollable (genetic), sympathy is anticipated as well as opposition to such hiring policies. METHOD We conducted multivariate analyses with data from two nationally representative surveys of U.S. adults. CONCLUSION Our findings supported the hypotheses, showing that sympathy and lack of anger toward obese people are strongly determined by a genetic attribution for obesity. Moreover, sympathy and the genetic attribution are significant predictors of opposition to hiring policies that discriminate against obese people. Finally, in a second study, chief among several causal attributions for obesity-lack of will power, lack of exercise, marketing of foods, and genetics-we discovered biological attribution functions as the key predictor of perceptions that obese people are frequent targets of discrimination. We suggest governments and the food industry should be more attuned to the underlying beliefs of the public about the causes of obesity when formulating programs and policies to address the issue.
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Affiliation(s)
- Mark R Joslyn
- Department of Political Science, 1541 Lilac Lane, 504 Blake Hall, University of Kansas, Lawrence, KS, 66044, USA
| | - Donald P Haider-Markel
- Department of Political Science, 1541 Lilac Lane, 504 Blake Hall, University of Kansas, Lawrence, KS, 66044, USA.
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