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Borg K, Faulkner N, Slattery P, Tear MJ. Understanding and Changing Community Attitudes Toward Vulnerable Families: A Review of Literature and Practice. FAMILY & COMMUNITY HEALTH 2024; 47:66-79. [PMID: 37747843 DOI: 10.1097/fch.0000000000000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Communities can play an important role in protecting children and supporting vulnerable families. However, there is currently a lack of understanding of what communities actually think and do regarding these groups. The purpose of this study was to review and synthesize evidence on community attitudes and behaviors toward vulnerable families. A rapid systematic literature review was conducted, supplemented by 6 semistructured interviews with experienced practitioners. Four databases were searched using key words related to community attitudes and behaviors, parents and families, and family and child protection services. Database searches returned 10 135 unique records, of which 23 met the inclusion criteria. The identified articles investigated a range of attitudes and behaviors, including reporting abuse and neglect; assisting victims of intimate partner violence; attitudes toward parenting practices; and participating in activities that build social support and social capital. Correlates of these attitudes and behaviors included sociodemographic characteristics, individual differences, community characteristics, and incident characteristics. A number of interventions to change community attitudes and behaviors were also identified. Practitioners indicated that success factors for interventions included facilitating active participation from community members; using multifaceted approaches; and increasing empathy toward vulnerable families. Despite increasing evidence around how community members think and act toward vulnerable families, more (particularly review-level) research is needed to determine how to effectively change these attitudes and behaviors.
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Affiliation(s)
- Kim Borg
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Clayton, Victoria, Australia
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Jia J, Van Horn L, Linder JA, Ackermann RT, Kandula NR, O'Brien MJ. Menu Calorie Label Use and Diet Quality: a Cross-Sectional Study. Am J Prev Med 2023; 65:1069-1077. [PMID: 37433378 PMCID: PMC11192142 DOI: 10.1016/j.amepre.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/13/2023]
Abstract
INTRODUCTION Menu calorie labeling has been implemented in food service businesses to promote healthy food choices; however, evidence is limited on whether label use is associated with healthier dietary intake. This study examined the association between menu calorie label use and diet quality and whether it varied by weight status. METHODS Adults in the National Health and Nutrition Examination Survey 2017-2018 who visited restaurants were included. Menu calorie label use was categorized as did not notice labels, noticed labels, and used labels. Diet quality was measured using the Healthy Eating Index 2015 (maximum score 100) by two 24-hour diet recalls. The association between menu calorie label use and diet quality was examined using multiple linear regression and tested for effect modification by weight status. Data were collected during 2017-2018 and analyzed during 2022-2023. RESULTS Of 3,312 participants (representing 195,167,928 U.S. adults), 43% did not notice labels, 30% noticed labels, and 27% used labels. Using labels was associated with 4.0 points (95% CI 2.2, 5.8) higher Healthy Eating Index 2015 scores than not noticing labels. Healthy Eating Index 2015 scores in those using labels were higher for adults with normal BMI (3.4 points; 95% CI=0.2, 6.7), overweight (6.5 points; 95% CI=3.6, 9.5), and obesity (3.0 points; 95% CI=1.0, 5.1) (p-interaction=0.0004) than those who did not notice labels. CONCLUSIONS Using menu calorie labels was associated with modestly healthier diet quality than not noticing labels, regardless of weight status. This suggests that providing caloric information may help some adults with food decisions.
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Affiliation(s)
- Jenny Jia
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Linda Van Horn
- Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jeffrey A Linder
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ronald T Ackermann
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Namratha R Kandula
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Matthew J O'Brien
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Graça J, Campos L, Guedes D, Roque L, Brazão V, Truninger M, Godinho C. How to enable healthier and more sustainable food practices in collective meal contexts: A scoping review. Appetite 2023; 187:106597. [PMID: 37178929 DOI: 10.1016/j.appet.2023.106597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
Collective meal contexts such as restaurants, cafeterias and canteens can help accelerate transitions to healthier and more sustainable diets. However, evidence from intervention studies on these contexts lacks integration. This scoping review aimed to map determinants of dietary change in collective meal contexts across multiple settings, interventions, target groups, and target behaviors. The review provided two main outcomes: (i) identifying intervention components to promote dietary change in collective meal contexts, based on the existing body of evidence; and (ii) classifying and integrating these intervention components into an overarching framework of behavior change (i.e., COM-B system). The review encompassed twenty-eight databases via two indexing services and extracted information from 232 primary sources (27,458 records selected for title and abstract screening, 574 articles selected for full-text screening). We identified a total of 653 intervention activities, which were classified into intervention components and grouped under three broad themes, namely contextual and environmental changes, social influence, and knowledge and behavioral regulation. Multi-component interventions tended to report overall positive outcomes. The review proposes several directions for future research, including: (i) moving toward more theory-based interventions in collective meal contexts; (ii) providing more detailed information about intervention settings, implementation, target groups, activities, and materials; and (iii) improving the use of open science practices in the field. Furthermore, the review offers a free, original, open-access list and synthesis of 277 intervention studies in collective meal contexts, which can help intervention planners and evaluators optimize their efforts to promote healthier and more sustainable food practices in these contexts.
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Affiliation(s)
- João Graça
- University of Groningen, Groningen, the Netherlands; Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal.
| | - Lúcia Campos
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal; Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | - David Guedes
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal; Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | - Lisa Roque
- Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | | | - Monica Truninger
- 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
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Fogolari N, Souza AD, Bernardo GL, Uggioni PL, Oliveira RC, Rodrigues VM, Proença RPC, Fernandes AC. Qualitative menu labelling in university restaurants and its influence on food choices: A systematic review and synthesis without meta-analysis. NUTR BULL 2023; 48:160-178. [PMID: 37161615 DOI: 10.1111/nbu.12612] [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: 08/08/2022] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 05/11/2023]
Abstract
Qualitative menu labelling can be defined as descriptive or non-numerical interpretive labels (e.g. traffic light labelling, healthy food symbols, messages or ingredient lists). Qualitative information seems to have a positive influence on consumers' food choices, particularly in institutional food service establishments, such as in universities. The aim of this systematic review was to assess the influence of different formats of qualitative menu labelling on food choices in university restaurants. This systematic review was guided by the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) and Synthesis Without Meta-Analysis (SWiM) and conducted vote counting of studies based on the direction of effect. Studies were retrieved from Cochrane Library, Scopus, MEDLINE, LILACS, SciELO and Web of Science databases and reference lists of selected articles. Experimental and quasi-experimental studies were included. Two independent researchers searched and extracted the data and assessed the methodological quality using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. From the initial search (460 records), four papers were selected, plus one paper identified in a previous study and a further six from an update search, totalling 11 included studies, reporting 14 different interventions (n = 499 174). Types of interventions included the use of symbols and the inclusion of traffic light labelling. Outcomes of interest were food choice, expressed as mean, median or percent healthy food choices or purchases. Qualitative menu labels increased healthy food choices and/or purchase behaviour, with 10 of 12 interventions favouring the intervention (83%; 95%CI 55-95%; p = 0.0386). Most of the studies favouring the intervention used healthy food symbols for healthier foods or food components, alone or in association with another intervention and were of moderate and weak quality. These findings may serve as a basis for the implementation of nutrition information policies in university restaurants.
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Affiliation(s)
- Natalia Fogolari
- Department of Nutrition and the Nutrition in Foodservice Research Centre (NUPPRE) of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Aretusa D Souza
- Department of Nutrition and the Nutrition in Foodservice Research Centre (NUPPRE) of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Greyce L Bernardo
- Department of Nutrition, NUPPRE, and the Nutrition Postgraduate Program of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Paula L Uggioni
- Department of Nutrition, NUPPRE, and the Nutrition Postgraduate Program of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Renata C Oliveira
- NUPPRE and the Catholic University Centre of Santa Catarina, Joinville, Santa Catarina, Brazil
| | - Vanessa M Rodrigues
- NUPPRE and the Nutrition Postgraduate Program of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Rossana P C Proença
- Department of Nutrition, NUPPRE, and the Nutrition Postgraduate Program of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Ana C Fernandes
- Department of Nutrition, NUPPRE, and the Nutrition Postgraduate Program of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Gao J, Keenan OE, Johnson AS, Wilhelm CA, Paul R, Racine EF. The COVID-19 Pandemic, Rising Inflation, and Their Influence on Dining Out Frequency and Spending. Nutrients 2023; 15:nu15061373. [PMID: 36986103 PMCID: PMC10058983 DOI: 10.3390/nu15061373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Abstract
Background: High intake of food away from home is associated with poor diet quality. This study examines how the COVID-19 pandemic period and Food Away from Home (FAFH) inflation rate fluctuations influenced dining out behaviors. Methods: Approximately 2800 individuals in Texas reported household weekly dining out frequency and spending. Responses completed prior to the COVID-19 pandemic (2019 to early 2020) were compared to the post-COVID-19 period (2021 through mid-2022). Multivariate analysis with interaction terms was used to test study hypotheses. Results and Conclusion: From the COVID-19 period (before vs. after), the unadjusted frequency of dining out increased from 3.4 times per week to 3.5 times per week, while the amount spent on dining out increased from $63.90 to $82.20. Once the relationship between dining out (frequency and spending) was adjusted for FAFH interest rate and sociodemographic factors, an increase in dining out frequency post-COVID-19 remained significant. However, the unadjusted increase in dining out spending did not remain significant. Further research to understand the demand for dining out post-pandemic is warranted.
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Affiliation(s)
- Jingjing Gao
- Texas A&M AgriLife Research, Texas A&M University, 1380 A&M Circle, El Paso, TX 79927, USA
- Correspondence:
| | - Odessa E. Keenan
- Texas A&M AgriLife Extension Service, Texas A&M University, 17360 Coit Road, Dallas, TX 75252, USA
| | - Abbey S. Johnson
- Texas A&M AgriLife Research, Texas A&M University, 1380 A&M Circle, El Paso, TX 79927, USA
| | - Carissa A. Wilhelm
- Texas A&M AgriLife Extension Service, Texas A&M University, 17360 Coit Road, Dallas, TX 75252, USA
| | - Rajib Paul
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, USA
| | - Elizabeth F. Racine
- Texas A&M AgriLife Research, Texas A&M University, 1380 A&M Circle, El Paso, TX 79927, USA
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O’Brien L, Randjelovic I. Intermediary Services to Assist People With Disabilities to Implement Individualized Funding Plans: A Rapid Systematic Review. JOURNAL OF DISABILITY POLICY STUDIES 2022. [DOI: 10.1177/10442073221130529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A systematic review was conducted to describe, and evaluate the effectiveness and cost-effectiveness of, intermediary services to support people with a disability to implement individualized funding plans. We included six records, including one subanalysis of randomized trial data, three qualitative studies, and two systematic reviews (reporting on 73 and 18 studies, respectively). No studies directly compared “consumer-directed plan plus intermediary services” to “consumer-directed plan with no/alternative intermediary,” so effectiveness of these interventions is uncertain. There is qualitative evidence from the perspective of disability planners and workers that intermediary interventions are important enablers of successful plan implementation. There is also qualitative evidence from consumer and family perspectives that external support is required to successfully navigate self-directed systems and that strong, trusting, and collaborative relationships with both paid and unpaid individuals in the person’s support network were facilitators of successful plan implementation. There was evidence of disabling practices and attitudes among some support agencies, resulting in coordinators being very risk averse in order to safeguard their clients. Suggestions for future research include carefully planned and ethically robust comparative trial designs, clear description and consistent delivery of interventions, and long-term evaluation of impact. The protocol was published on PROSPERO (CRD42020177607).
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Affiliation(s)
- Lisa O’Brien
- National Disability Insurance Agency, Melbourne, Victoria, Australia
- Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Ivana Randjelovic
- National Disability Insurance Agency, Melbourne, Victoria, Australia
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Nykänen EP, Hoppu U, Löyttyniemi E, Sandell M. Nudging Finnish Adults into Replacing Red Meat with Plant-Based Protein via Presenting Foods as Dish of the Day and Altering the Dish Sequence. Nutrients 2022; 14:nu14193973. [PMID: 36235625 PMCID: PMC9573669 DOI: 10.3390/nu14193973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/20/2023] Open
Abstract
This study investigated whether Finnish working-aged omnivores (n = 163) could be nudged into replacing red meat with a fava-bean-based protein source via “Dish of the Day” (DoD) and main dish sequence alteration (SA) strategies in a controlled real-world Finnish self-service buffet restaurant with smart scales (Flavoria® Multidisciplinary Research Platform). A further aim was to study whether the effectiveness of the strategies differed by gender, age, and body mass index. The participants were assigned one of four experimental treatments: standard menu (T1), DoD (T2), standard menu + SA (T3), or DoD + SA (T4). The participants could choose any amount or combination of salad components and casseroles with minced meat or fava bean protein. Being subjected to a DoD menu and/or SA had no effect on main dish choice or the share of the meat-based dish in the meal weight. Men were more likely to choose a meat-based main dish and had a higher share of the meat dish in the meal weight compared to women, but no differences were observed between those aged 18–29, 30–44, or 45–65 years or those who were normal weight, overweight, or obese. Future studies should have a larger sample size and investigate food choice motives such as price or environmental awareness.
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Affiliation(s)
- Esa-Pekka Nykänen
- Functional Foods Forum, University of Turku, 20014 Turku, Finland
- Correspondence:
| | - Ulla Hoppu
- Functional Foods Forum, University of Turku, 20014 Turku, Finland
| | | | - Mari Sandell
- Functional Foods Forum, University of Turku, 20014 Turku, Finland
- Department of Food and Nutrition, University of Helsinki, 00014 Helsingin Yliopisto, Finland
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Yi S, Kanetkar V, Brauer P. Nudging food service users to choose fruit- and vegetable-rich items: Five field studies. Appetite 2022; 173:105978. [PMID: 35247476 DOI: 10.1016/j.appet.2022.105978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/18/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022]
Abstract
Although nudging has been found to promote the choice of healthy foods in lab studies and ad-hoc field studies, relatively little research is available regarding effectiveness in real food venues that operate for profit. The paucity of empirical studies providing "proof of implementation" reveals the difficulty of applying previous empirical findings on nudging to mass-eating food services contexts, which serve meals to a lot of individuals daily. Based on the typology of choice architecture in food choice contexts, we closely collaborated with the in-house food service operator to devise and implement five nudge interventions to promote fruits and vegetables (FV) in university cafeterias. Each study was conducted for one 12-week semester or more over a three-year period. In the first two studies, non-verbal point-of-purchase prompting increased the choice of kale/spinach supplemented smoothies and whole fruits from baskets. In Study 3, the combination of sizing and point-of-purchase non-verbal prompting increased the sale of large size vegetable-rich bowls from a stir-fry grill. In Study 4, the proximity type of nudging by altering the position of the healthier option in a sandwich bar in combination with non-verbal prompting increased the sale of sandwiches containing spinach. In Study 5, the combination of sizing and proximity of large vs. small sized plates and serving spoons had no effect on sale of self-serve items in a salad bar. All the interventions except for Study 5 produced a moderate effect in increasing the choice of FV-rich items. We recommend that hospitality and food service operators consider operational parameters and simultaneously adopt more than one nudging components to achieve a sizable effect. Future randomized controlled trials are needed to implement choice architecture techniques in collaboration with food service companies.
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Affiliation(s)
- Sunghwan Yi
- Department of Marketing & Consumer Studies, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.
| | - Vinay Kanetkar
- Department of Marketing & Consumer Studies, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.
| | - Paula Brauer
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada.
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Jansen L, van Kleef E, Van Loo EJ. The use of food swaps to encourage healthier online food choices: a randomized controlled trial. Int J Behav Nutr Phys Act 2021; 18:156. [PMID: 34863208 PMCID: PMC8642761 DOI: 10.1186/s12966-021-01222-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Online grocery stores offer opportunities to encourage healthier food choices at the moment that consumers place a product of their choice in their basket. This study assessed the effect of a swap offer, Nutri-Score labeling, and a descriptive norm message on the nutrient profiling (NP) score of food choices in an online food basket. Additionally explored was whether these interventions made it more motivating and easier for consumers to select healthier foods and whether potential effects were moderated by consumer health interest. METHODS Hypotheses were tested with a randomized controlled trial (RCT) in a simulated online supermarket. Dutch participants (n = 550) chose their preferred product out of six product options for four different categories (breakfast cereals, crackers, pizza, and muesli bars). Participants were randomly allocated to one of eight groups based on the interventions in a 2 (Nutri-Score: present, not present) X 2 (swap offer: present, not present) X 2 (norm message: present, not present) between subject design. The primary outcome was the difference in combined NP score of product choices, for which a lower score represented a healthier product. RESULTS Swap offer (B = - 9.58, 95% CI: [- 12.026; - 7.132], Ƞ2 = 0.098) and Nutri-Score labeling (B = - 3.28, 95% CI: [- 5.724; -.829], Ƞ2 = 0.013) significantly improved the combined NP score compared to the control condition (NP score M = 18.03, SD = 14.02), whereas a norm message did not have a significant effect (B = - 1.378, 95% CI [- 3.825; 1.070], Ƞ2 = 0.002). No evidence was found that interventions made it more motivating or easier for consumers to select healthier food, but situational motivation significantly influenced the healthiness score of food choices for both swap offer (b = - 3.40, p < .001) and Nutri-Score (b = - 3.25, p < .001). Consumer health interest only significantly moderated the influence of Nutri-Score on ease of identifying the healthy food option (b = .23, p = .04). CONCLUSIONS Swap offer and Nutri-Score labeling were effective in enhancing healthy purchase behavior in the online store environment. TRIAL REGISTRATION This study was retrospectively registered in the ISRCTN database on 02-09-2021 ( ISRCTN80519674 ).
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Affiliation(s)
- Laura Jansen
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - Ellen van Kleef
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - Ellen J Van Loo
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands.
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Consumer preferences for the use of an innovative digital menu solution in public food service settings in four European countries. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Hanssen NSJ, Linschooten JO, van Lieverloo JHM, Roodenburg AJC. What Is on the Menu?-A Quantitative Analysis on Label Format among (Potential) Restaurant Guests and Restaurant Owners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312500. [PMID: 34886226 PMCID: PMC8656631 DOI: 10.3390/ijerph182312500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/19/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022]
Abstract
About 20% of energy intake in the Netherlands is consumed out-of-home. Eating out-of-home is associated with higher energy intake and poorer nutrition. Menu labeling can be considered a promising instrument to improve dietary choices in the out-of-home sector. Effectiveness depends on the presentation format of the label and its attractiveness and usability to restaurant guests and restaurant owners. This exploratory study investigated which menu labeling format would be mostly appreciated by (a) (potential) restaurant guests (n386) and (b) the uninvestigated group of restaurant owners (n41) if menu labeling would be implemented in Dutch full-service restaurants. A cross-sectional survey design was used to investigate three distinct menu labeling formats: a simple health logo; (star) ranking and calorie information. Questionnaires were used as study tool. Ranking has been shown to be the most appreciated menu labeling format by both (potential) restaurant guests and owners. Statistical analysis showed that label preference of potential restaurant guests was significantly associated with age, possibly associated with level of education, and not associated with health consciousness. In summary, we found that ranking is the most appreciated menu label format according to both (potential) restaurant guests and restaurant owners, suggesting it to be a promising way to improve healthy eating out-of-home.
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Mandracchia F, Tarro L, Llauradó E, Valls RM, Solà R. Interventions to Promote Healthy Meals in Full-Service Restaurants and Canteens: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:1350. [PMID: 33919552 PMCID: PMC8073122 DOI: 10.3390/nu13041350] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
Out-of-home eating is increasing, but evidence about its healthiness is limited. The present systematic review and meta-analysis aimed to elucidate the effectiveness of full-service restaurant and canteen-based interventions in increasing the dietary intake, food availability, and food purchase of healthy meals. Studies from 2000-2020 were searched in Medline, Scopus, and Cochrane Library using the PRISMA checklist. A total of 35 randomized controlled trials (RCTs) and 6 non-RCTs were included in the systematic review and analyzed by outcome, intervention strategies, and settings (school, community, workplace). The meta-analysis included 16 RCTs (excluding non-RCTs for higher quality). For dietary intake, the included RCTs increased healthy foods (+0.20 servings/day; 0.12 to 0.29; p < 0.001) and decreased fat intake (-9.90 g/day; -12.61 to -7.19; p < 0.001), favoring the intervention group. For food availability, intervention schools reduced the risk of offering unhealthy menu items by 47% (RR 0.53; 0.34 to 0.85; p = 0.008). For food purchases, a systematic review showed that interventions could be partially effective in improving healthy foods. Lastly, restaurant- and canteen-based interventions improved the dietary intake of healthy foods, reduced fat intake, and increased the availability of healthy menus, mainly in schools. Higher-quality RCTs are needed to strengthen the results. Moreover, from our results, intervention strategy recommendations are provided.
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Affiliation(s)
- Floriana Mandracchia
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
| | - Lucia Tarro
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
- Institut d’Investigació Sanitaria Pere Virgili, 43204 Reus, Spain
| | - Elisabet Llauradó
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
| | - Rosa Maria Valls
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
| | - Rosa Solà
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (F.M.); (L.T.); (R.M.V.); (R.S.)
- Institut d’Investigació Sanitaria Pere Virgili, 43204 Reus, Spain
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
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Fuster M, Handley MA, Alam T, Fullington LA, Elbel B, Ray K, Huang TTK. Facilitating Healthier Eating at Restaurants: A Multidisciplinary Scoping Review Comparing Strategies, Barriers, Motivators, and Outcomes by Restaurant Type and Initiator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041479. [PMID: 33557280 PMCID: PMC7915132 DOI: 10.3390/ijerph18041479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022]
Abstract
Restaurants are understudied yet increasingly important food environment institutions for tackling diet-related diseases. This scoping review analyzes research and gray literature (n = 171 records) to assess which healthy eating promotion strategies have been implemented in restaurants and the associated motivations, barriers, and outcomes, compared by restaurant type (corporate/chain vs. independently owned restaurants) and initiator (restaurant-initiated vs. investigator-initiated). We found that the most commonly reported strategy was the increase of generally healthy offerings and the promotion of such offerings. Changes in food availability were more common among corporate restaurants and initiated by restaurants, while environmental facilitators were more commonly initiated by investigators and associated with independently owned restaurants. Aside from those associated with revenue, motivations and barriers for healthy eating promoting strategies varied by restaurant type. While corporate restaurants were also motivated by public health criticism, independently owned restaurants were motivated by interests to improve community health. Revenue concerns were followed by food sourcing issues in corporate restaurants and lack of interest among independently owned restaurants. Among reporting sources, most outcomes were revenue positive. This study shows the need for practice-based evidence and accounting for restaurant business models to tailor interventions and policies for sustained positive changes in these establishments.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, New York, NY 11210, USA;
- Correspondence:
| | - Margaret A. Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA 94158, USA;
| | - Tamara Alam
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, New York, NY 11210, USA;
| | - Lee Ann Fullington
- Library, Brooklyn College, City University of New York, Brooklyn, New York, NY 11210, USA;
| | - Brian Elbel
- Department of Population Health, New York University Grossman School of Medicine, and Wagner Graduate School of Public Service, New York University, New York, NY 10016, USA;
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA;
| | - Terry T-K Huang
- Department of Community Health and Social Sciences and Center for Systems and Community Design, City University of New York Graduate School of Public Health and Health Policy, New York, NY 10027, USA;
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14
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Fruh S, Williams S, Hayes K, Hauff C, Hudson GM, Sittig S, Graves RJ, Hall H, Barinas J. A practical approach to obesity prevention: Healthy home habits. J Am Assoc Nurse Pract 2021; 33:1055-1065. [PMID: 33534281 PMCID: PMC8313625 DOI: 10.1097/jxx.0000000000000556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/06/2020] [Indexed: 12/11/2022]
Abstract
ABSTRACT Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.
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Affiliation(s)
- Sharon Fruh
- Research, Evaluation, and Development, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Susan Williams
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Katey Hayes
- Department of Psychology, University of South Alabama, Mobile, Alabama
| | - Caitlyn Hauff
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Geoffrey M. Hudson
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Scott Sittig
- Department of Information Systems and Technology, University of South Alabama, Mobile, Alabama
| | - Rebecca J. Graves
- Special Projects and Evaluation, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Heather Hall
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Jennifer Barinas
- Combined-Integrated Clinical & Counseling Psychology Program, University of South Alabama, Mobile, Alabama
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16
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Borg K, Boulet M, Smith L, Bragge P. Digital Inclusion & Health Communication: A Rapid Review of Literature. HEALTH COMMUNICATION 2019; 34:1320-1328. [PMID: 29889560 DOI: 10.1080/10410236.2018.1485077] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Information and communication technologies can be a valuable tool for enhancing health communication. However, not everyone is utilising the wide suite of digital opportunities. This disparity has the potential to exacerbate existing social and health inequalities, particularly among vulnerable groups such as those who are in poor health and the elderly. This review aimed to systematically identify the common barriers to, and facilitators of, digital inclusion. A comprehensive database search yielded 969 citations. Following screening, seven systematic reviews and three non-systematic reviews were identified. Collectively, the reviews found that physical access continues to be a barrier to digital inclusion. However, provision of access alone is insufficient, as digital ability and attitude were also potential barriers. Social support, direct user experience and collaborative learning/design were identified as key strategies to improve inclusion. These review findings provide guidance for health communication practitioners in designing and implementing effective programmes in the digital environment.
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Affiliation(s)
- Kim Borg
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University
| | - Mark Boulet
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University
| | - Liam Smith
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University
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17
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Forberger S, Reisch L, Kampfmann T, Zeeb H. Nudging to move: a scoping review of the use of choice architecture interventions to promote physical activity in the general population. Int J Behav Nutr Phys Act 2019; 16:77. [PMID: 31481090 PMCID: PMC6724306 DOI: 10.1186/s12966-019-0844-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background Nudges are used to alter lifestyles and thus curb the rise of non-communicable diseases. Physical activity is a core prevention strategy to reduce the burden of non-communicable diseases. This paper aims to (1) give an overview of the scope of interventions using choice architecture techniques to promote physical activity at the population levels and (2) identify research gaps by analysing the different approaches in terms of class and type of intervention used. Methods A systematic electronic database search was combined with snowball citation sampling of a starter set of publications to search for studies published through October 2018 reporting interventions to promote physical activity at the population level using choice architecture techniques. The methodology of the Joanna Briggs Institute for Scoping Reviews was applied. Results In all, 35 publications were included. Most of the interventions used point-of-choice prompts tested at railway stations, shopping malls and airports (N = 27). Eight studies were online studies. While all studies were aimed at the general population, details, if reported at all, were vague and basic. All studies focused on individual-level lifestyle behaviour. None of the studies attempted to alter population-based lifestyle behaviour. Online and “real-world” approaches were rarely combined. Neither, interventions targeting meso- and macro-level structures nor combinations of individual-level and specific meso- or macro-level interventions were found. Conclusion Nudging is in principle an effective approach to promote physical activity within the general population. However, there are large gaps in research. Available opportunities have not yet been exhausted. Further research is needed that is explicitly based on behavioural insights and covering the full range of nudging approaches, particularly focussing on theoretical developments, practical feasibility tests and scale-up activities. Electronic supplementary material The online version of this article (10.1186/s12966-019-0844-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
| | - L Reisch
- Leibniz-Chair, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Copenhagen Business School, MSC, Dalgas Have 15, 2000, Frederiksberg, Denmark
| | - T Kampfmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - H Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Health Sciences Bremen, University of Bremen, Bremen, Germany
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Jo HS, Jung SM. Evaluation of Food Labeling Policy in Korea: Analyzing the Community Health Survey 2014-2017. J Korean Med Sci 2019; 34:e211. [PMID: 31432651 PMCID: PMC6698451 DOI: 10.3346/jkms.2019.34.e211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/15/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND As Koreans adopt more Westernized diets, consumer demands for processed food products are growing. The Korean government implemented a food labeling system to help people reasonably choose processed foods. This study investigated the utilization of these food labels among Koreans, as well as demographic differences between users and non-users of food labels, ultimately presenting foundational data for strategies to enhance dietary lifestyles by facilitating the use of food labeling. METHODS Data from the 2014-2017 Community Health Survey were used. The Cochran-Armitage trend test was performed to investigate whether food labeling awareness and utilization increase over time; a data mining technique called decision tree analysis was then used to examine the effects of sociodemographic factors on the use of food labeling for each of the 4 years. RESULTS Food labeling awareness increased by 4.5% over 4 years; the Cochran-Armitage trend test showed that this increase was statistically significant (χ² = 1,068.21; P < 0.001). Food labeling utilization increased significantly but marginally, by 0.3%, over 4 years (χ² = 20.154; P < 0.001). Decision tree analysis showed that food labeling users comprised mainly women in their 30s-50s currently in graduate school or with a graduate degree; the non-user group comprised mainly divorced/widowed/separated people in their 70s who were elementary school grads or below. CONCLUSION Education level, which could be related to health literacy, substantially affected the use of food labeling. Education level is a typical socioeconomic index, and if people who are less educated tend not to use food labeling, it can lead to health inequity. Thus, food labeling should be reformed with consideration of health literacy among the less-educated social classes. From a health communication perspective, images and pictures can boost consumers' understanding, which should be considered to improve comprehensibility of food labeling.
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Affiliation(s)
- Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Su Mi Jung
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea.
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The effects of bowl size and portion size on food intake and fullness ratings in a sample of Japanese men. Public Health Nutr 2018; 21:3216-3222. [PMID: 30079861 DOI: 10.1017/s1368980018001842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Portion sizes and bowl sizes may be related to food intake and perceived fullness. The objective of the present study was to investigate the effects of portion size and bowl size and possible interactions between these variables on food intake and fullness in a sample of Japanese men. DESIGN Participants ate four different experimental meals across four weeks and completed questionnaires about their fullness using a visual analogue scale administered before and after meals. The four meal patterns included consistent portions of several foods commonly eaten together in typical Japanese meals, along with 150 g of rice served in a small rice bowl (diameter of 11·5 cm), 150 g of rice served in a large rice bowl (diameter of 13·5 cm), 250 g of rice served in a small rice bowl or 250 g of rice served in a large rice bowl. SETTING Tokyo.SubjectTwenty-one adult men participated in the study. RESULTS Portion size had a significant main effect on rice intake (F (1,20)=83, P<0·001) and fullness (F (1,20)=8·0, P=0·010), but no significant effects of bowl size on the outcome variables were found. The interactions between portion size and bowl size on intake and fullness were not significant. CONCLUSIONS The sample of Japanese men showed an influence of portion size on food intake. Further research is needed to clarify the combined effects of bowl size and portion size on intake and fullness.
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