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Cao X. Character-Audience Racial Matching, Prescription Opioid Misuse Experience, and the Effectiveness of Anti-Prescription Opioid Messages: The Mediating Roles of Identification and Perceived Severity. HEALTH COMMUNICATION 2024:1-14. [PMID: 39120432 DOI: 10.1080/10410236.2024.2386717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
An online experiment was conducted among a convenience sample of non-Hispanic young Black and White Americans to test the impact of character-audience racial matching on intentions to avoid (mis)using prescription opioids while considering the mediating roles of identification and perceived severity and the moderating role of prescription opioid misuse experience. It found that the racial matching had a positive overall impact on the behavioral intentions. The impact was partly explained by three pathways: 1) identification, 2) perceived severity, and 3) the sequential pathway of identification and perceived severity. It also found that prescription opioid misuse experience moderated the impact of the racial matching on identification. As a result, the racial matching was found to influence the behavioral intentions of participants with different prescription opioid misuse experience via somewhat different routes. These findings have a number of theoretical and practical implications.
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Affiliation(s)
- Xiaoxia Cao
- Department of Communication, University of Wisconsin-Milwaukee
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Kumanyika SK. A Black American Nutrition Scholar and Advocate: My Journey. Annu Rev Nutr 2024; 44:1-24. [PMID: 38603557 DOI: 10.1146/annurev-nutr-062322-030901] [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] [Indexed: 04/13/2024]
Abstract
I started my journey as a nutrition scholar in 1974 when I began PhD studies at Cornell University. My journey has been rich with opportunity. I engaged in research on diet-related risks for cardiovascular diseases, diabetes, and cancer, partly motivated by my strong commitment to addressing health disparities affecting Black Americans. Obesity became my major focus and would eventually involve both US and global lenses. This focus was also linked to other dietary intake issues and health disparities and drew on knowledge I had gained in my prior study and practice of social work. I positioned myself as a bridge builder across nutrition, epidemiology, and public health, advocating for certain new ways of thinking and acting in these spheres and in the academy itself. Life skills honed during my formative years living within racially segregated contexts have been critical to any successes I have achieved.
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Affiliation(s)
- Shiriki K Kumanyika
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Harris JL, Taillie LS. More than a Nuisance: Implications of Food Marketing for Public Health Efforts to Curb Childhood Obesity. Annu Rev Public Health 2024; 45:213-233. [PMID: 38109516 DOI: 10.1146/annurev-publhealth-090419-102616] [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] [Indexed: 12/20/2023]
Abstract
Fifteen years ago, public health experts urged industry, governments, and advocates to take action to dramatically improve the unhealthy food-marketing environment surrounding children in order to address the global childhood obesity crisis. Since then, research has confirmed that food marketing to children has far-reaching negative effects on their diets and health, takes advantage of adolescent vulnerabilities, and contributes to health disparities. In addition, digital marketing has profoundly changed young people's engagement with brands. Moreover, reliance on industry self-regulation as a solution has proven ineffective. Government-led policies have been more successful, but they remain limited in scope and challenging to adopt and implement. New approaches are necessary to increase public and policy maker awareness that food marketing is more than a nuisance, that it threatens the long-term health of children and adolescents worldwide, and that meaningful governmental action is urgently required to curtail industry's negative impact on young people's well-being.
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Affiliation(s)
- Jennifer L Harris
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut, USA;
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Graupensperger S, Calhoun BH, Fairlie AM, Lee CM. Exposure to media with alcohol-related content across young adulthood: Associations with risky drinking and consequences among high-risk 2- and 4-year college students. Drug Alcohol Rev 2024; 43:98-110. [PMID: 36992619 PMCID: PMC11412155 DOI: 10.1111/dar.13654] [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: 10/25/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Exposure to media with alcohol-related content is a known risk for alcohol use and related harms among young people. The present study used longitudinal self-report data on exposure to media with alcohol-related content to examine age trajectories across young adulthood and to estimate associations with heavy episodic drinking (HED) and negative consequences. METHOD Participants were 201 high-risk young adults enrolled in 2- and 4-year colleges (ages 18-25 at screening; 63.7% female). Repeated assessments occurred at four timepoints across a 12-month period. RESULTS Self-reported exposure to both positively and negatively portrayed alcohol-related media content decreased with age. Between-persons, controlling for alcohol use frequency, exposure to positive alcohol-related media content was positively associated with HED, and exposure to negative alcohol-related media content was inversely associated with HED; no within-person effects on HED were significant. For negative consequences, controlling for alcohol quantity, exposure to positive media content was associated with more negative consequences both between- and within-persons. Unexpectedly, exposure to negatively portrayed media content was positively associated with negative consequences at the within-person level. DISCUSSION AND CONCLUSIONS Trajectories in exposure to media with alcohol-related content showed that relatively younger participants reported greater exposure, highlighting the need for policy and prevention efforts to protect this vulnerable demographic. Findings generally indicated that positive portrayals of alcohol use increase alcohol-related risks. Moreover, increased exposure to negative portrayals in a given assessment was associated with more negative consequences-potentially by normalising or glorifying high-risk drinking and consequences, though mechanistic/causal research is needed.
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Affiliation(s)
| | - Brian H Calhoun
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Anne M Fairlie
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Christine M Lee
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
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Okoli CB, Arrington N, Hall J, Paulus T, Miles I, Shieh J, Sharpe K, Cotwright CJ. Black Parents' Perceptions and Barriers to Limiting Sugar-Sweetened Beverages Among Young Children: A Social Cognitive Theory Application. Child Obes 2024; 20:23-34. [PMID: 36576994 DOI: 10.1089/chi.2022.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Introduction: Sugar-sweetened beverages (SSBs) are a major contributor to obesity among young children 0 to 5 years of age. In addition, parental beverage intake influences children's beverage intake. Objective: This study explores Black parents' perceptions about and barriers to limiting SSBs among young children. Methods: Twenty-seven Black parents participated in six focus groups conducted across the state of Georgia. Questions grounded in Social Cognitive Theory (SCT) assessed perceived health impacts of SSBs and water consumption, influences of beverage choices, barriers to limiting SSB intake, and resources needed to overcome barriers. Before the focus group sessions, participants completed a demographic survey. Quantitative data were analyzed using R statistical software. Focus group sessions were analyzed using NVivo. Results: Family and cultural norms, price, taste, flavor, water safety, tantrums, and product placement at grocery stores primarily influenced beverage choice and consumption. Restaurant refills, price, lack of confidence, advertisements, cravings, tantrums, and budget were perceived barriers to drinking more water and fewer SSBs daily. Resources Black parents noted would help in promoting and serving healthy beverages to their young children included education on beverage recommendations, training on how to read nutrition labels, healthy alternatives, and the presence of support systems. Conclusion: Findings from this study will inform interventions to reduce SSB intake among Black families with young children.
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Affiliation(s)
- Chisom B Okoli
- Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, GA, USA
| | | | - Jori Hall
- College of Education, University of Georgia, Athens, GA, USA
| | - Trena Paulus
- Division of Family Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Isa Miles
- Isa Miles Consulting, Atlanta, GA, USA
| | - Josephine Shieh
- Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, GA, USA
| | - Kassidy Sharpe
- Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, GA, USA
| | - Caree J Cotwright
- Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, GA, USA
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Palzes VA, Chi FW, Weisner C, Kline-Simon AH, Satre DD, Sterling S. Risk profiles of adults with heavy alcohol use: Drinking patterns, behavioral and metabolic factors, health problems, and racial and ethnic disparities. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2301-2312. [PMID: 38151789 PMCID: PMC10755251 DOI: 10.1111/acer.15211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Heavy alcohol use is a growing risk factor for chronic disease, yet little is known about its co-occurrence with other risk factors and health problems. This study aimed to identify risk profiles of adults with heavy alcohol use and examined potential disparities by race and ethnicity. METHODS This cross-sectional study included 211,333 adults with heavy alcohol use (in excess of daily or weekly limits recommended by National Institute on Alcohol Abuse and Alcoholism) between June 1, 2013 and December 31, 2014 in Kaiser Permanente Northern California. Latent class analysis was used to examine how heavy drinking patterns clustered with other behavioral and metabolic risk factors and health problems to form risk profiles. Multinomial logistic regression models were fit to examine associations between race, ethnicity, and risk profiles. RESULTS A 5-class model was selected as best fitting the data and representing clinically meaningful risk profiles: (1) "heavy daily drinking and lower health risks" (DAILY, 44.3%); (2) "substance use disorder and mental health disorder" (SUD/MH, 2.3%); (3) "heavy weekly drinking and lower health risks" (WEEKLY, 19.6%); (4) "heavy daily drinking and more health risks" (DAILY-R, 18.5%); (5) "heavy weekly drinking and more health risks" (WEEKLY-R, 15.3%). American Indian or Alaska Native (AIAN) and Black patients had higher odds than White patients of being in the SUD/MH, DAILY-R, and WEEKLY-R profiles than the DAILY profile. AIAN, Black, and Latino/Hispanic patients had higher odds than White patients of being in the SUD/MH, DAILY-R, and WEEKLY-R profiles rather than the WEEKLY profile. CONCLUSIONS AIAN, Black, and Latino/Hispanic patients with self-reported heavy drinking were more likely to be in risk profiles with greater alcohol consumption, more health risks, and higher morbidity. Targeted, culturally appropriate interventions for heavy alcohol use that may address other modifiable risk factors are needed to work towards health equity.
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Affiliation(s)
- Vanessa A. Palzes
- Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612-2304
| | - Felicia W. Chi
- Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612-2304
| | - Constance Weisner
- Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612-2304
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, 675 18 Street, San Francisco, CA 94107
| | - Andrea H. Kline-Simon
- Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612-2304
| | - Derek D. Satre
- Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612-2304
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, 675 18 Street, San Francisco, CA 94107
| | - Stacy Sterling
- Center for Addiction and Mental Health Research, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612-2304
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, 675 18 Street, San Francisco, CA 94107
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine
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Czaplicki L, Duren M, Kelley D, Moran MB, Welding K, Kennedy RD. Flavored electronic nicotine delivery systems ads (2019-2020) on traditional U.S. Media by audience demographics. Prev Med Rep 2023; 35:102346. [PMID: 37576840 PMCID: PMC10413146 DOI: 10.1016/j.pmedr.2023.102346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 05/18/2023] [Accepted: 07/23/2023] [Indexed: 08/15/2023] Open
Abstract
The tobacco industry has historically targeted flavored products to specific U.S. consumer segments, including young people, women, and systemically marginalized groups based on race, ethnicity, or sexual/gender identity. Existing research on target marketing is focused on cigarettes and smokeless tobacco. In contrast, studies of target marketing of electronic nicotine delivery systems (ENDS)-a growing segment of the U.S. tobacco product market - are much more limited. We analyzed data on 496 ENDS ads and audience demographics to explore the extent to which flavored ENDS ads on cable television (n = 25 ads), terrestrial radio (n = 412 ads), and in print consumer magazines (n = 59 ads) are targeted to different demographic groups based on age, sex, and race/ethnicity. We observed flavor-related content in one-quarter to one-third of ENDS ad occurrences during 2019-2020. Across all media outlets examined, audience age was an important factor in explaining the likelihood of ENDS ads containing flavor-related content. For example, within a television channel, there were 3.82 [95% confidence interval (CI): 1.39-10.49] times greater odds that an ENDS ad contained flavor-related content versus not for every 1% increase in the proportion of U.S. youth ages 6-17 watching a television show. In addition, there were 2.13 [95 %CI: 1.30-3.51] and 1.61 [95 %CI:1.60-1.63] times greater odds that an ENDS ad contained flavor-related content versus not in cable television and radio stations, respectively, for every 1% increase in the proportion of male audience members. Race/ethnicity was an important explanatory factor for the presence of flavor-related content on radio but not television ENDS ads. Our findings suggest differences in target marketing of flavored ENDS by media outlet and audience demographics.
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Affiliation(s)
- Lauren Czaplicki
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Michelle Duren
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Dannielle Kelley
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, United States
| | - Meghan B. Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kevin Welding
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ryan David Kennedy
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Olarte DA, Petimar J, James P, Cooksey-Stowers K, Cash SB, Rimm EB, Economos CD, Rohmann M, Blossom JC, Chen Y, Deo R, Cohen JFW. Trends in Quick-Service Restaurants near Public Schools in the United States: Differences by Community, School, and Student Characteristics. J Acad Nutr Diet 2023; 123:923-932.e1. [PMID: 36740187 PMCID: PMC10200734 DOI: 10.1016/j.jand.2023.01.016] [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: 07/11/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND More than one-third of children and adolescents consume foods from quick-service restaurants (QSRs) daily, which is associated with an increased risk of diet-related adverse health conditions. OBJECTIVE To examine trends in the proximity of top-selling QSR chains to all public schools across the United States between 2006 and 2018 by community-, school-, and student-level characteristics. DESIGN This longitudinal study examined changes in the number QSRs between the 2006-2007 and 2017-2018 school years using data from National Center for Education Statistics, Infogroup US Historical Business Data, and the US Department of Agriculture's Economic Research Service. STATISTICAL ANALYSIS A mixed-model analysis of variance using census tract as a random effect and accounting for repeated measures by school was used to examine the proximity of QSRs near schools. Models adjusted for demographic characteristics and census tract population density. Data were analyzed in 2021. RESULTS During 2006, 9% of schools had QSRs within 400 m, and 25% of schools in the most populated areas had at least one QSR within 400 m. There were more QSRs near schools with a high percentage of poverty (12%), and near schools with high school students with the highest population of Black or African American (16%) and Hispanic or Latino (18%) students. By 2018, the percent of all public schools within 400 m of QSRs increased to 12%. The increase over time was greater near schools with a high percentage of poverty (16%) and near schools with high school students with the highest population of Black or African American students (22%) and Hispanic or Latino (23%) students. CONCLUSIONS This is the first nationwide study to examine trends in QSR proximity to all public schools. QSRs were most likely to be located near schools with high school students, near schools with a high percentage of poverty, and near schools with a higher proportion of racial and ethnic minority students. Over time, there were greater increases in QSRs near these schools which may have important implications for children's health and diet-related disparities.
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Affiliation(s)
- Deborah A Olarte
- Center for Health Inclusion, Research and Practice, Department of Nutrition and Public Health, School of Health Sciences, Merrimack College, North Andover, Massachusetts.
| | - Joshua Petimar
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, East Boston, Massachusetts
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, East Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kristen Cooksey-Stowers
- Allied Health Sciences, Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Marlaina Rohmann
- Center for Health Inclusion, Research and Practice, Department of Nutrition and Public Health, School of Health Sciences, Merrimack College, North Andover, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jeffrey C Blossom
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Yuting Chen
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Rinki Deo
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Juliana F W Cohen
- Center for Health Inclusion, Research and Practice, Department of Nutrition and Public Health, School of Health Sciences, Merrimack College, North Andover, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Rollins N, Piwoz E, Baker P, Kingston G, Mabaso KM, McCoy D, Ribeiro Neves PA, Pérez-Escamilla R, Richter L, Russ K, Sen G, Tomori C, Victora CG, Zambrano P, Hastings G. Marketing of commercial milk formula: a system to capture parents, communities, science, and policy. Lancet 2023; 401:486-502. [PMID: 36764314 DOI: 10.1016/s0140-6736(22)01931-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/21/2022] [Accepted: 09/26/2022] [Indexed: 02/10/2023]
Abstract
Despite proven benefits, less than half of infants and young children globally are breastfed in accordance with the recommendations of WHO. In comparison, commercial milk formula (CMF) sales have increased to about US$55 billion annually, with more infants and young children receiving formula products than ever. This Series paper describes the CMF marketing playbook and its influence on families, health professionals, science, and policy processes, drawing on national survey data, company reports, case studies, methodical scoping reviews, and two multicountry research studies. We report how CMF sales are driven by multifaceted, well resourced marketing strategies that portray CMF products, with little or no supporting evidence, as solutions to common infant health and developmental challenges in ways that systematically undermine breastfeeding. Digital platforms substantially extend the reach and influence of marketing while circumventing the International Code of Marketing of Breast-milk Substitutes. Creating an enabling policy environment for breastfeeding that is free from commercial influence requires greater political commitment, financial investment, CMF industry transparency, and sustained advocacy. A framework convention on the commercial marketing of food products for infants and children is needed to end CMF marketing.
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Affiliation(s)
- Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, WHO, Geneva, Switzerland.
| | | | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | | | | | - David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | | | | | - Linda Richter
- University of the Witwatersrand, DSI-NRF Centre of Excellence in Human Development, Johannesburg, South Africa
| | - Katheryn Russ
- Department of Economics, University of California, Davis, CA, USA
| | - Gita Sen
- Public Health Foundation of India, Bangalore, India
| | - Cecília Tomori
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | - Gerard Hastings
- Institute for Social Marketing, University of Stirling, Stirling, UK
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10
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Cassidy O, Tanofsky-Kraff M, Waters AJ, Shank LM, Pine A, Quattlebaum M, DeLeon PH, Bragg M, Sbrocco T. The impact of racially-targeted food marketing and attentional biases on consumption in Black adolescent females with and without obesity: Pilot data from the Black Adolescent & Entertainment (BAE) study. PLoS One 2023; 18:e0279871. [PMID: 36662840 PMCID: PMC9858861 DOI: 10.1371/journal.pone.0279871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 12/16/2022] [Indexed: 01/22/2023] Open
Abstract
Unhealthy food advertisements ("advertisements" hereafter referred to as "ads") are linked to poor diet and obesity, and food companies disproportionally target Black youth. Little is known about the mechanisms whereby food ads influence diet. One possibility may be racially-targeted ads that appeal to Black youth. Those with food-related attentional biases may be especially vulnerable. The objective of this project was to assess the feasibility and initial effects of a pilot study testing the influence of racially-targeted food ads and food-related attentional biases on eating behaviors among a sample of Black adolescent females. Feasibility of recruitment, retention, and procedures were examined. Participants (N = 41, 12-17y) were randomized to view a television episode clip of the Big Bang Theory embedded with either four 30-second racially-targeted food ads or neutral ads. A computer dot probe task assessed food-related attentional biases. The primary outcome was caloric consumption from a laboratory test meal. Interactions based on weight and ethnic identity were also examined. Analyses of variance and regressions were used to assess main and interaction effects. Exposure to racially-targeted food ads (versus neutral ads) did not affect energy consumption (p > .99). Although not statistically significant, adolescents with obesity consumed nearly 240 kcal more than non-overweight adolescents (p = 0.10). There were no significant preliminary effects related to food-related attentional biases or ethnic identity (ps = 0.22-0.79). Despite a non-significant interaction, these data provide preliminary support that adolescents with obesity may be particularly vulnerable to racially-targeted food ads. An adequately powered trial is necessary to further elucidate the associations among racially-targeted food ads among Black adolescent girls with obesity.
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Affiliation(s)
- Omni Cassidy
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
- Department of Population Health, NYU Langone Health/Grossman School of Medicine, New York, New York, United States of America
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
| | - Andrew J. Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
| | - Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
| | - Abigail Pine
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
| | - Mary Quattlebaum
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
| | - Patrick H. DeLeon
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
- Daniel K. Inouyé Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Marie Bragg
- Department of Population Health, NYU Langone Health/Grossman School of Medicine, New York, New York, United States of America
- College of Global Public Health, New York University, New York, New York, United States of America
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America
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11
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Djojosoeparto SK, Kamphuis CBM, Harrington JM, Løvhaug AL, Roos G, Sawyer ADM, Stronks K, Terragni L, Torheim LE, Vandevijvere S, Poelman MP, van Lenthe FJ. How theory can help to understand the potential impact of food environment policies on socioeconomic inequalities in diet: an application of Bourdieu's capital theory and the scarcity theory. Eur J Public Health 2022; 32:iv66-iv70. [PMID: 36444101 PMCID: PMC9706114 DOI: 10.1093/eurpub/ckac052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Government policies that promote healthy food environments are considered promising to reduce socioeconomic inequalities in diet. Empirical evidence of effects on these inequalities, however, is relatively scarce and, with a few exceptions, tends to be inconclusive. We use two contemporary theories that help to understand socioeconomic inequalities in health and health-related behaviours (Bourdieu's capital theory and Mullainathan and Shafir's scarcity theory) to reason how policies influencing food environments may differentially impact lower and higher socioeconomic groups. In essence, these theories enable us to understand how specific elements of broader daily living conditions (e.g. social practices that lead to habitus formation, material conditions that shape experiences of scarcity) may lead to a greater benefit of certain food environment policies for the healthfulness of diets of lower or higher socioeconomic groups. We conclude that the application of theories on the mechanisms underlying socioeconomic inequalities in health can help to guide future empirical studies in testing theory-based hypotheses on differential effects of policies, and thereby enhance the development of effective policies tackling socioeconomic inequalities in dietary intakes.
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Affiliation(s)
- Sanne K Djojosoeparto
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Gun Roos
- Consumption Research Norway (SIFO), OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Alexia D M Sawyer
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Laura Terragni
- Department of Nursing and Health Promotion, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, OsloMet—Oslo Metropolitan University, Oslo, Norway
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, The Netherlands
| | - Frank J van Lenthe
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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12
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Goodspeed E, Dunn HK, Pearlman DN. Virtual Delivery of World Diabetes Day During COVID-19: Lessons Learned from the Field. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2120579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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13
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Fraser KT, Ilieva RT, James CJ, Chong VP, Shapiro S, Willingham C, Roberts C, Freudenberg N. Use of environmental scan to assess density, content, and variation of predatory food and beverage marketing in New York City. Health Place 2022; 76:102843. [PMID: 35728454 DOI: 10.1016/j.healthplace.2022.102843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/28/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
Abstract
To explore the presence of predatory food and beverage marketing in different neighborhoods in New York City (NYC), this study describes the methodology of an outdoor environmental scan of the physical environment. The study was conducted in four NYC neighborhoods over a three-week period, in which pairs of trained researchers canvassed designated neighborhoods to document the presence of food and beverage marketing using photographs taken on digital smart phone devices. Commercial areas in the vicinity of NYC Public Schools and NYC Housing Authority campuses located in four neighborhoods with the highest and lowest nutrition related health indicators were studied: South Bronx, Pelham Throggs Neck, Upper West Side, Chelsea/Greenwich Village. Advertisements were coded against 50+ indicators to quantify pertinent variables including the frequency and content of food and beverages advertised and all forms of predatory marketing observed. Comparisons of prevalence and content of food and beverage advertisements and predatory marketing were made across neighborhoods with the highest and lowest health indicators, using chi-squared analysis, and a significance level of p < 0.05. This article demonstrates a disproportionate presence of predatory marketing in low income NYC neighborhoods with negative health outcomes compared to wealthier neighborhoods. Further, this paper demonstrates the benefits and limitations of using an environmental scan methodology to assess predatory food and beverage marketing in a large urban area such as NYC.
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Affiliation(s)
- Katherine Tomaino Fraser
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States.
| | - Rositsa T Ilieva
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Charita Johnson James
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Valerie Peter Chong
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Sarah Shapiro
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Craig Willingham
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | | | - Nicholas Freudenberg
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
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14
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Zhou M, Ramírez AS, Chittamuru D. Toward a Recipe for Deep versus Surface Level Tailoring: Mixed-Methods Validation of Message Features to Reduce Sugary Beverage Consumption. JOURNAL OF HEALTH COMMUNICATION 2022; 27:211-221. [PMID: 35730401 PMCID: PMC9391283 DOI: 10.1080/10810730.2022.2089301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Targeted marketing contributes to the overconsumption of sugary beverages, which contributes to obesity and diabetes disparities among African American and Latino populations in the U.S. Health communicators can similarly use culturally tailored messages to decrease sugary beverage consumption among these groups, yet the specific strategies to operationalize cultural tailoring-the message components essential for such tailoring-are ill-described. We sought to identify and validate authentically created, culturally tailored messages using a multiple step mixed-methods approach. First, we used a snowball approach to identify nutrition education messages targeting ethnic minorities about reducing sugary beverage consumption (N = 85). Via content analysis, we assessed message features (character gender and race/ethnicity), level of change of the appeal (individual or social), and level of cultural tailoring (surface level tailoring in the form of matching character gender and race/ethnicity with target audience versus deep structural tailoring in the form of appealing to values is an effective message strategy). The highest-rated videos were then validated by a sample of the target audience using a quantitative survey and qualitative comments (N = 76). The results inform theorizing on message tailoring and provide a validated pool of culturally relevant messages intended both to reduce intentions to consume sugary beverages and to engage in social change actions.
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Affiliation(s)
- Mi Zhou
- Department of Public Health, University of California
Merced, Merced, USA
| | - A. Susana Ramírez
- Department of Public Health, University of California
Merced, Merced, USA
| | - Deepti Chittamuru
- Department of Public Health, University of California
Merced, Merced, USA
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15
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Winkler MR, Lenk K, Erickson D, Laska MN. Secular trends and customer characteristics of sweetened beverage and water purchasing at US convenience and other small food stores, 2014-2017. Int J Behav Nutr Phys Act 2022; 19:37. [PMID: 35361242 PMCID: PMC8973807 DOI: 10.1186/s12966-022-01268-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background Cardiovascular health is linked to sugar- and artificially-sweetened beverages (SSBs and ASBs). Prior studies document declines in SSB purchases. However, it is unclear if similar trends exist at convenience and other small food outlets, which often serve lower-income communities and where objective point-of-sales data are difficult to obtain. We examined trends (2014–2017) in observed SSB, ASB, and water purchases at convenience and other small stores as well as differences in purchasing by customer characteristics. Methods We used observational purchase data collected annually (2014–2017) from 3010 adult customers at 147 randomly-sampled stores in Minneapolis/St. Paul, USA. SSB sub-types included any ready-to-drink sweetened soda, fruit, sport, energy, tea, or other drink, and ASBs included artificially-sweetened versions. Unsweetened water included ready-to-drink water. Mixed regression models examined trends over time and associations with customer characteristics, accounting for customers nested within stores and stores repeatedly measured over time. Results Nearly 50% of purchases included an SSB. Approximately 10% included an ASB. There was no evidence of change over time in SSB or ASB purchasing. Customer purchasing of unsweetened water significantly increased over time (5.7 to 8.4%; P for trend = 0.05). SSB purchasing was highest among men, young adults, customers with lower education/ income, and customers that shopped frequently. ASB purchasing was highest among women, those 40–59 years, non-Hispanic White, Hispanic, and customers with higher education/ income. Conclusions Despite research suggesting previous declines in SSB consumption and purchasing in the US, we identified a persistent, high trend of SSB purchasing overtime at convenience and other small food stores. Consumption of SSBs and water are growing targets for public policy and health campaigns. Results demonstrate additional work is needed curb sweetened beverage purchasing and promote water purchasing at convenience and other small food stores, which are often prevalent in low-income and marginalized communities.
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Affiliation(s)
- Megan R Winkler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA. .,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Kathleen Lenk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Darin Erickson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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16
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Contextualizing Breast Implant Removal Patterns with Google Trends: Big Data Applications in Surgical Demand. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4005. [PMID: 35127299 PMCID: PMC8812673 DOI: 10.1097/gox.0000000000004005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022]
Abstract
The demand for breast implant removal (BIR) has increased substantially in recent years. This study leveraged large datasets available through Google Trends to understand how changes in public perception could be influencing surgical demand, both geographically and temporally.
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17
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Lee K, Freudenberg N. Public Health Roles in Addressing Commercial Determinants of Health. Annu Rev Public Health 2022; 43:375-395. [DOI: 10.1146/annurev-publhealth-052220-020447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The shared challenges posed by the production and distribution of health-harming products have led to growing recognition of the need for policy learning and transfer across problems, populations, and social contexts. The commercial determinants of health (CDoH) can serve as a unifying concept to describe the population health consequences arising from for-profit actors and activities, along with the social structures that sustain them. Strategies to mitigate harms from CDoH have focused on behavioral change, regulation, fiscal policies, consumer and citizen activism, and litigation. While there is evidence of effective measures for each strategy, approaches that combine strategies are generally more impactful. Filling gaps in evidence can inform ways of adapting these strategies to specific populations and social contexts. Overall, CDoH are addressed most effectively not through siloed efforts to reduce consumption of health-harming products, but instead as a set of integrated strategies to reduce exposures to health-harming commercial actors and activities. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Nicholas Freudenberg
- School of Public Health and Health Policy, City University of New York, New York, NY, USA
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18
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Choi YY, Andreyeva T, Fleming-Milici F, Harris JL. U.S. Households' Children's Drink Purchases: 2006-2017 Trends and Associations With Marketing. Am J Prev Med 2022; 62:9-17. [PMID: 34922654 DOI: 10.1016/j.amepre.2021.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/20/2021] [Accepted: 06/11/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Sugar-sweetened beverages contribute a large proportion of added sugar in young children's diets; yet, companies market sugar-sweetened children's drinks extensively to children and parents. This study examines the changes in children's drink purchases by U.S. households with young children and the associations with marketing practices. METHODS Longitudinal Nielsen U.S. household panel data provided monthly volume purchases by children's drink category (sugar-sweetened fruit drinks and flavored water and unsweetened juices) among households with young children (aged 1-5 years) from 2006 to 2017. Differences by household race/ethnicity and income were assessed. The 2-part models examined the associations between household purchases and marketing (including price and brand TV advertising) for each category, controlling for sociodemographics. Data were collected and analyzed in 2019-2020. RESULTS Households' volume purchases of children's fruit drinks and unsweetened juices declined from 2006 to 2017, whereas flavored water purchases increased. Non-Hispanic Black households purchased significantly more fruit drinks (351.23 fluid ounces/month, 95% CI=342.63, 359.82) than non-Hispanic White (204.43 fluid ounces/month, 95% CI=201.81, 207.05) and Hispanic (222.63 fluid ounces/month, 95% CI=217.11, 228.15) households. Low-income households purchased more fruit drinks and fewer unsweetened juices than higher-income households (p<0.001). TV brand advertising was positively associated with purchases across all categories, and this relationship was stronger for low-income households (p<0.05). CONCLUSIONS Despite expert recommendations that young children do not consume Sugar-sweetened beverages, households with young children purchase more sweetened fruit drinks than unsweetened juices. Extensive TV advertising for children's drink brands may exacerbate the racial and income disparities in sugar-sweetened beverage purchases. Public health initiatives to address sugar-sweetened beverage consumption by young children and restrictions on marketing sugar-sweetened beverages to children are necessary.
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Affiliation(s)
- Yoon Y Choi
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, Connecticut.
| | - Tatiana Andreyeva
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, Connecticut; Department of Agricultural & Resource Economics, University of Connecticut, Storrs, Connecticut
| | | | - Jennifer L Harris
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, Connecticut
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19
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Casais B, Proença JF. The use of positive and negative appeals in social advertising: a content analysis of television ads for preventing HIV/AIDS. INTERNATIONAL REVIEW ON PUBLIC AND NONPROFIT MARKETING 2022; 19:623-647. [PMCID: PMC8541814 DOI: 10.1007/s12208-021-00318-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/10/2021] [Indexed: 05/29/2023]
Abstract
Effectiveness of positive and negative appeals in social advertising depends on the target audience and the context in which the messages are applied. However, there is a dearth of research on the real use of such message appeals by social marketers. Considering the importance of practice theory in social marketing, this paper presents a longitudinal research on the use of positive and negative appeals in social advertising, since communication has been particularly relevant in social marketing practices over time. A content analysis of 375 HIV/AIDS-prevention TV ads from four European countries indicates that positive appeals had expressive and higher proportional use over the entire period under analysis. The researchers identified positive appeals, especially in rhetoric, music and voice tonality, while negative appeals are more prevalent in narratives and signs from the scenes. The results show that participation of public figures promoting coping response was low, but increasing over time. Negative appeals are mostly expressed in countries with higher uncertainty avoidance indexes and higher epidemic incidence rates. The prevalence of positive and negative appeals in social advertisements informs about practitioners’ choices when designing campaigns and allows analyzing congruity between the use of appeals and theoretical recommendations for social marketing effectiveness. The study opens the discussion about the application of social marketing theories into practice and how the analysis of social marketing practices may contribute to design innovative theoretical approaches, particularly regarding a topic plagued by inconsistent findings in the literature on message-frame effectiveness in social marketing. The practitioners’ preference for the gain-frame perspective over the protection motivation approach allows inquiring about the motivations and constraints leading to that choice.
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Affiliation(s)
- Beatriz Casais
- School of Economics and Management, and CICS.NOVA.UMinho, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - João F. Proença
- Faculty of Economics, University of Porto, Porto, Portugal
- Advance/CSG, ISEG, University of Lisbon, Lisboa, Portugal
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20
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Barnhill A, Ramírez AS, Ashe M, Berhaupt-Glickstein A, Freudenberg N, Grier SA, Watson KE, Kumanyika S. The Racialized Marketing of Unhealthy Foods and Beverages: Perspectives and Potential Remedies. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2022; 50:52-59. [PMID: 35243999 PMCID: PMC9014864 DOI: 10.1017/jme.2022.8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We propose that marketing of unhealthy foods and beverages to Black and Latino consumers results from the intersection of a business model in which profits come primarily from marketing an unhealthy mix of products, standard targeted marketing strategies, and societal forces of structural racism, and contributes to health disparities.
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21
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Jensen ML, Choi YY, Fleming-Milici F, Harris JL. Caregivers' Understanding of Ingredients in Drinks Served to Young Children: Opportunities for Nutrition Education and Improved Labeling. Curr Dev Nutr 2022; 6:nzab151. [PMID: 35047722 PMCID: PMC8760421 DOI: 10.1093/cdn/nzab151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Against expert recommendations, sugar-sweetened beverages, especially fruit drinks, are consumed by young children. Misperceptions about drink ingredients and healthfulness can contribute to caregivers' provision. OBJECTIVES To assess caregivers' reasons for serving sweetened fruit-flavored drinks and unsweetened juices to their young children (1-5 y) and perceptions of product healthfulness and drink ingredients. METHODS A cross-sectional online survey assessed participants' (n = 1614) perceptions of sweetened fruit-flavored drinks (fruit drinks and flavored water) and unsweetened juices (100% juice and water/juice blends) provided to their child in the past month, including product healthfulness, reasons for providing, and knowledge of product ingredients [added sugar, nonnutritive sweeteners (NNSs), percentage juice]. One-factor ANOVA compared perceived healthfulness of drink categories and types of sugar and NNSs, and differences between participants who could compared with those who could not accurately identify drink ingredients. RESULTS Participants' top reasons for providing sweetened drinks included child liking it, being inexpensive, child asking for it, and being a special treat. Participants perceived 100% juice as healthiest, followed by juice/water blends, flavored waters, and, lastly, fruit drinks (P < 0.05). Many participants inaccurately believed the fruit drink or flavored water they served their child most often did not contain NNSs (59.0% and 64.9%) and/or added sugars (20.1% and 42.2%), when in fact they did, and 81.3-91.1% overestimated the percentage juice in the drink. Perceived healthfulness of fruit drinks was associated with caregivers' belief that the drink contained added sugar (P < 0.05), but not with their belief that it contained NNS; increased accuracy was associated with decreased perceived healthfulness (P < 0.05). CONCLUSIONS Inaccurate understanding of added sugar, NNSs, and percentage juice in drinks served to young children was common and could contribute to sugary drink provision. Public health efforts should seek to improve labeling practices and revise nutrition education messages.
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Affiliation(s)
- Melissa L Jensen
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | - Yoon Y Choi
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Frances Fleming-Milici
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Jennifer L Harris
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
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22
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Cohen N. Roles of Cities in Creating Healthful Food Systems. Annu Rev Public Health 2021; 43:419-437. [PMID: 34936824 DOI: 10.1146/annurev-publhealth-052220-021059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Over the past several decades, cities worldwide have attempted to reconfigure their food systems to improve public health, advance social justice, and promote environmental resilience using diverse municipal policies, often with the support of stakeholder-led governance mechanisms such as food policy councils. This article reviews the roles that cities have played in creating healthful urban food systems and the effects of those policies on public health. It explains that despite wide-ranging policy initiatives, disparities in food insecurity and malnourishment persist. It concludes by describing several promising pathways for urban food policy: engaging in food-focused urban planning to create equitable food environments; treating policies to address inequality and social justice as upstream food policies; considering the effects of new business models such as online food retail in urban food policy making; and using food procurement as a lever to influence regional, national, and global food systems. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Nevin Cohen
- Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA;
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23
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Woo Baidal JA, Nichols K, Charles N, Chernick L, Duong N, Finkel MA, Falbe J, Valeri L. Text Messages to Curb Sugar-Sweetened Beverage Consumption among Pregnant Women and Mothers: A Mobile Health Randomized Controlled Trial. Nutrients 2021; 13:nu13124367. [PMID: 34959919 PMCID: PMC8703966 DOI: 10.3390/nu13124367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Racial, ethnic, and socioeconomic disparities in childhood obesity in the United States (U.S.) originate in early life. Maternal sugar-sweetened beverage (SSB) consumption is an early life risk factor for later offspring obesity. The goal of this study was to test the effects of policy-relevant messages delivered by text messages mobile devices (mHealth) on maternal SSB consumption. In this three-arm 1-month randomized controlled trial (RCT), pregnant women or mothers of infants in predominantly Hispanic/Latino New York City neighborhoods were randomized to receive one of three text message sets: graphic beverage health warning labels, beverage sugar content information, or attention control. The main outcome was change in maternal self-reporting of average daily SSB consumption from baseline to one month. Among 262 participants, maternal SSB consumption declined over the 1-month period in all three arms. No intervention effect was detected in primary analyses. In sensitivity analyses accounting for outliers, graphic health warning labels reduced maternal SSB consumption by 28 kcal daily (95% CI: −56, −1). In this mHealth RCT among pregnant women and mothers of infants, graphic health warning labels and beverage sugar content information did not reduce maternal SSB consumption.
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Affiliation(s)
- Jennifer A. Woo Baidal
- Department of Pediatrics, Columbia University Irving Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA; (K.N.); (N.D.); (M.A.F.)
- Correspondence: ; Tel.: +1-(212)-305-5903
| | - Kelsey Nichols
- Department of Pediatrics, Columbia University Irving Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA; (K.N.); (N.D.); (M.A.F.)
| | - Nalini Charles
- New York Presbyterian Hospital Special Supplemental Nutrition Program for Women, Infants and Children, 622 W. 168th Street, New York, NY 10032, USA;
| | - Lauren Chernick
- Department of Emergency Medicine, Columbia University Irving Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA;
| | - Ngoc Duong
- Department of Pediatrics, Columbia University Irving Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA; (K.N.); (N.D.); (M.A.F.)
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
| | - Morgan A. Finkel
- Department of Pediatrics, Columbia University Irving Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA; (K.N.); (N.D.); (M.A.F.)
| | - Jennifer Falbe
- Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, CA 95616, USA;
| | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
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24
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Miller A, Cassidy O, Greene T, Arshonsky J, Albert SL, Bragg MA. A Qualitative Analysis of Black and White Adolescents' Perceptions of and Responses to Racially Targeted Food and Drink Commercials on Television. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111563. [PMID: 34770078 PMCID: PMC8583111 DOI: 10.3390/ijerph182111563] [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] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/17/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022]
Abstract
Food and beverage marketing is a major driver of childhood obesity, and companies target their least nutritious products to Black youth. However, little is known about adolescents' perceptions of and responses to racially targeted food marketing. In this qualitative study, we investigated how Black and White adolescents perceived and responded to racially targeted television commercials for food and beverages. We recruited 39 adolescents aged 12-17 years in New York City to watch a series of commercials and then participate in an in-depth interview using a semi-structured interview guide. The research team recorded, transcribed, and analyzed interviews using ATLAS.ti. Overall, participants responded positively to commercials that featured celebrities. They were also able to recognize the commercials and reported they had been exposed to marketing from these companies on social media and in subways/buses. Many participants considered the advertised brands as healthy or able to enhance athletic performance because of their endorsement by or association with athletes. Participants also understood that marketers were using racial targeting in their ads but that targeting did not translate into improved perceptions or responses towards advertised products. These findings suggest the need to empirically evaluate and further explore Black and White adolescents' responses to racially targeted food marketing.
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Affiliation(s)
- Alysa Miller
- Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison St., 1059 BSB, Chicago, IL 60607, USA;
| | - Omni Cassidy
- Department of Population Health, New York University (NYU) Grossman School of Medicine, 180 Madison Ave., New York, NY 10016, USA; (O.C.); (T.G.); (J.A.); (S.L.A.)
| | - Tenay Greene
- Department of Population Health, New York University (NYU) Grossman School of Medicine, 180 Madison Ave., New York, NY 10016, USA; (O.C.); (T.G.); (J.A.); (S.L.A.)
| | - Josh Arshonsky
- Department of Population Health, New York University (NYU) Grossman School of Medicine, 180 Madison Ave., New York, NY 10016, USA; (O.C.); (T.G.); (J.A.); (S.L.A.)
| | - Stephanie L. Albert
- Department of Population Health, New York University (NYU) Grossman School of Medicine, 180 Madison Ave., New York, NY 10016, USA; (O.C.); (T.G.); (J.A.); (S.L.A.)
| | - Marie A. Bragg
- Department of Population Health, New York University (NYU) Grossman School of Medicine, 180 Madison Ave., New York, NY 10016, USA; (O.C.); (T.G.); (J.A.); (S.L.A.)
- Department of Public Health Nutrition, NYU School of Global Public Health, 708 Broadway, New York, NY 10003, USA
- Correspondence:
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25
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Duran AC, Mialon M, Crosbie E, Jensen ML, Harris JL, Batis C, Corvalán C, Taillie LS. [Soluciones relacionadas con el entorno alimentario para prevenir la obesidad infantil en América Latina y en la población latina que vive en Estados Unidos]. Obes Rev 2021; 22 Suppl 5:e13344. [PMID: 34708531 DOI: 10.1111/obr.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ana Clara Duran
- Núcleo de Estudos e Pesquisas em Alimentação (NEPA), Universidade Estadual de Campinas, Campinas, Brasil.,Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brasil
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublín, Irlanda
| | - Eric Crosbie
- School of Community and Health Sciences, University of Nevada, Reno, Nevada, EE. UU
| | - Melissa Lorena Jensen
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, EE. UU.,Escuela de Nutrición, Universidad de Costa Rica, San José, Costa Rica
| | - Jennifer L Harris
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, EE. UU
| | - Carolina Batis
- CONACYT, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Camila Corvalán
- Instituto de Nutricion y Tecnologia de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, Carolina del Norte, EE. UU
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Kong AY, Delamater PL, Gottfredson NC, Ribisl KM, Baggett CD, Golden SD. Sociodemographic inequities in tobacco retailer density: Do neighboring places matter? Health Place 2021; 71:102653. [PMID: 34461529 PMCID: PMC8490323 DOI: 10.1016/j.healthplace.2021.102653] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
We apply a spatial perspective to measure the extent to which the 2018 U.S. racial, ethnic, and socioeconomic composition of census tracts were each associated with tobacco retailer density within a tract and in its neighboring tracts (n = 71,409). A 10-percentage point increase in the Black population was associated with 0.07 (p < 0.05) more retailers per square mile within a focal tract and 0.35 (p < 0.001) more retailers per square mile in its neighbors on average. A greater percent of Hispanic/Latino residents was associated with more retailers per square mile, both within a focal tract (b = 0.95, p < 0.001) and in its neighbors 0.39 (p < 0.001). Inverse associations were observed for percent white. We also observed inequities by socioeconomic status. The overall magnitude of inequities may be underestimated if the spatial dependence between focal tracts and their neighbors are not taken into consideration. Policymakers should prioritize interconnected geographic areas experiencing high racialized and socioeconomic segregation when designing and implementing policies to reduce retail tobacco product availability.
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Affiliation(s)
- Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA.
| | - Paul L Delamater
- Department of Geography, University of North Carolina, Carolina Hall, Chapel Hill, NC, 27599-7435, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27599-7295, USA
| | - Chris D Baggett
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27599-7295, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7435, USA
| | - Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27599-7295, USA
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27
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Eaton TM, Kumanyika S, DiSantis KI, Yadeta K, Grier S. Black Community Conversations About Opposing Ethnically Targeted Marketing of Unhealthy Foods and Beverages. J Racial Ethn Health Disparities 2021; 9:1946-1956. [PMID: 34417762 PMCID: PMC8378522 DOI: 10.1007/s40615-021-01133-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
Efforts to reduce disparities in obesity prevalence affecting Black Americans are having limited success. One reason for this may be the disproportionate, ethnically targeted marketing of foods and beverages high in fat and sugar (FBHFS) to Black consumers. Such marketing promotes high consumption of FBHFS, leading to excess caloric intake and unintentional weight gain. We convened focus groups with Black men and women (total n = 57) in collaboration with community groups in three localities to elicit their views, as consumers and parents/caregivers, about targeted FBHFS marketing and potential ways to combat it. At each location, trained community members facilitated two sets of focus groups: one for adults aged 18 to 25 years and another for adults aged 26 to 55 years who had a 3-to-17-year-old child at home. Each group met twice to discuss food and beverage marketing practices to Black communities and reviewed a booklet about ethnically targeted marketing tactics in between. A directed content analysis of participant comments identified and explored salient themes apparent from initial summarization of results. Results show how parents are concerned with and critical of pervasive FBHFS marketing. In particular, comments emphasize the involvement of Black celebrities in FBHFS marketing—how and why they engage in such marketing and whether this could be shifted towards healthier foods. These findings suggest a potential role for counter marketing efforts focused on Black celebrity endorsements of FBHFS, possibly with a youth focus. They also underscore the need for additional, qualitative exploration of Black consumer views of ethnically targeted FBHFS marketing more generally.
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Affiliation(s)
- Tiffany M Eaton
- Department of Community Health & Prevention, Drexel University Dornsife School of Public Health, 3215 Market Street, 4th Floor, Philadelphia, PA, 19104, USA
| | - Shiriki Kumanyika
- Department of Community Health & Prevention, Drexel University Dornsife School of Public Health, 3215 Market Street, 4th Floor, Philadelphia, PA, 19104, USA.
| | | | - Kenna Yadeta
- Intramural Training Program, National Institute of Drug Abuse, Biomedical Research Center, Baltimore, MD, 21224, USA
| | - Sonya Grier
- Department of Marketing, Kogod School of Business, American University, Washington, DC, 20016, USA
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28
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Marketing to Children Inside Quick Service Restaurants: Differences by Community Demographics. Am J Prev Med 2021; 61:96-104. [PMID: 33994053 PMCID: PMC8277431 DOI: 10.1016/j.amepre.2021.01.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/04/2020] [Accepted: 01/12/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In the U.S., children regularly consume foods from quick-service restaurants, but little is known about the marketing strategies currently used inside quick-service restaurants. This study aims to validate a child-focused Environmental Assessment Tool for quick-service restaurants, evaluate marketing strategies inside and on the exterior of quick-service restaurants, and examine differences by community race/ethnicity or income. METHODS The inter-rater and test-retest reliability of the Environmental Assessment Tool were assessed across the top 5 national quick-service restaurant chains. Marketing techniques in 165 quick-service restaurants (33 per national chain) in socioeconomically and racially/ethnically diverse communities throughout New England were examined in 2018-2019. Mixed methods ANOVA examined the differences in marketing techniques in 2020. RESULTS The inter-rater and test-retest reliability of the Environmental Assessment Tool were high (Cohen's κ>0.80). Approximately 95% of quick-service restaurants marketed less healthy foods, whereas only 6.5% marketed healthy options. When examining the differences by community demographics, there were significantly more price promotion advertisements inside and on the exterior of quick-service restaurants in lower-income communities. In addition, there was a greater number of child-directed advertisements with cartoon or TV/movie characters as well as fewer healthy entrée options and more sugar-sweetened beverage and dessert options on the children's menu inside quick-service restaurants in communities with higher minority populations. CONCLUSIONS Environmental Assessment Tool is a valid tool to evaluate marketing inside quick-service restaurants. Results suggest that there is a substantial amount of unhealthy food and beverage marketing inside quick-service restaurants, with differences in the number and types of techniques used in lower-income and minority communities. Policies that limit quick-service restaurant marketing to children should be considered.
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29
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Rummo PE, Arshonsky JH, Sharkey AL, Cassidy OL, Bragg MA. Social Media Accounts of Food and Beverage Brands Have Disproportionately More Black and Hispanic Followers than White Followers. Health Equity 2021; 5:414-423. [PMID: 34235366 PMCID: PMC8237102 DOI: 10.1089/heq.2020.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction: On television, food companies promote their least nutritious products to Black and Hispanic youth more than White youth, but little is known about the extent to which Black and Hispanic adolescents may disproportionately engage with unhealthy food and beverage brands on social media relative to White adolescents. Methods: In 2019, we purchased and analyzed demographic data of social media users who followed 27 of the most marketed food/beverage brands on Instagram and Twitter. We used one-sample t-tests to compare percentages of Black, Hispanic, and White followers of the selected brands' accounts versus all social media accounts, and independent samples t-tests to compare followers of sugary versus low-calorie drink brands. We also used linear regression to examine associations between racially targeted marketing practices and the percentages of Black, Hispanic, and White followers on social media. Results: On Instagram, the percentage of Black followers of the selected brands (12.7%) was higher than the percentage of Black followers of any account (7.8%) (p<0.001). On Twitter, findings were similar for Hispanic users but opposite for White users. A higher racially targeted ratio was positively associated with the percentage of Black followers, and negatively associated with the percentage of White followers. Sugary drink brands had more Hispanic followers than low-calorie drink brands (p<0.001). Conclusions: Unhealthy food/beverage brands that target Black adolescents have a disproportionately higher percentage of Black followers on social media relative to White followers. These findings support the 2019 proposal to restrict racially targeted advertising through the Children's Online Privacy and Protection Act.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Josh H Arshonsky
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Andrea L Sharkey
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Omni L Cassidy
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Marie A Bragg
- Department of Population Health, New York University School of Medicine, New York, New York, USA.,NYU School of Global Public Health, New York, New York, USA
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30
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Duran AC, Mialon M, Crosbie E, Jensen ML, Harris JL, Batis C, Corvalán C, Taillie LS. Food environment solutions for childhood obesity in Latin America and among Latinos living in the United States. Obes Rev 2021; 22 Suppl 3:e13237. [PMID: 34152071 PMCID: PMC8365715 DOI: 10.1111/obr.13237] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/23/2022]
Abstract
The food environment is a major contributor to unhealthy diets in children and, therefore, to the increasing rates of obesity. Acclaimed by scholars across the world, Latin American countries have been leaders in implementing policies that target different aspects of the food environment. Evidence on the nature and to what extent children are exposed and respond to unhealthy food environments in the region and among Latinos in the United States is, however, deficient. The objective of this review is to use the integrated International Network for Food and Obesity/noncommunicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) framework to create healthy food environment to (i) compare the key elements of childhood obesity-related food environments in Latin America and for Latinos living in the United States; (ii) describe the evidence on solutions to improve childhood obesity-related food environments; and (iii) identify research priorities to inform solutions to fight childhood obesity in these populations. We found that an integrated body of evidence is needed to inform an optimal package of policies to improve food environments to which children in Latin America and Latino children in the United States are exposed and more efficiently translate policy solutions to help curb growing childhood obesity levels across borders.
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Affiliation(s)
- Ana Clara Duran
- Center for Food Studies and Research (NEPA)University of CampinasCampinasBrazil
- Center for Epidemiological Studies in Nutrition and HealthUniversity of São PauloSão PauloBrazil
| | - Melissa Mialon
- Trinity Business SchoolTrinity College DublinDublinIreland
| | - Eric Crosbie
- School of Community and Health SciencesUniversity of NevadaRenoNevadaUSA
| | - Melissa Lorena Jensen
- Rudd Center for Food Policy and ObesityUniversity of ConnecticutHartfordConnecticutUSA
- School of Nutrition, University of Costa RicaSan JoséCosta Rica
| | - Jennifer L. Harris
- Rudd Center for Food Policy and ObesityUniversity of ConnecticutHartfordConnecticutUSA
| | - Carolina Batis
- CONACYT, Health and Nutrition Research CenterNational Institute of Public HealthCuernavacaMexico
| | - Camila Corvalán
- Instituto de Nutricion y Tecnologia de AlimentosUniversity of ChileSantiagoChile
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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31
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Sigala DM, Stanhope KL. An Exploration of the Role of Sugar-Sweetened Beverage in Promoting Obesity and Health Disparities. Curr Obes Rep 2021; 10:39-52. [PMID: 33411311 PMCID: PMC7788552 DOI: 10.1007/s13679-020-00421-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The mechanistic role of sugar-sweetened beverage (SSB) in the etiology of obesity is undetermined. We address whether, compared to other foods, does consumption of SSB (1) automatically lead to failure to compensate for the energy it contains? (2) fail to elicit homeostatic hormone responses? (3) promote hedonic eating through activation of the brain's reward pathways? We followed the evidence to address: (4) Would restriction of targeted marketing of SSB and other unhealthy foods to vulnerable populations decrease their prevalence of obesity? RECENT FINDINGS The data are lacking to demonstrate that SSB consumption promotes body weight gain compared with isocaloric consumption of other beverages or foods and that this is linked to its failure to elicit adequate homeostatic hormone responses. However, more recent data have linked body weight gain to reward activation in the brain to palatable food cues and suggest that sweet tastes and SSB consumption heightens the reward response to food cues. Studies investigating the specificity of these responses have not been conducted. Nevertheless, the current data provide a biological basis to the body of evidence demonstrating that the targeted marketing (real life palatable food cues) of SSB and other unhealthy foods to vulnerable populations, including children and people of color and low socioeconomic status, is increasing their risk for obesity. While the mechanisms for the association between SSB consumption and body weight gain cannot be identified, current scientific evidence strongly suggests that proactive environmental measures to reduce exposure to palatable food cues in the form of targeting marketing will decrease the risk of obesity in vulnerable populations.
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Affiliation(s)
- Desiree M. Sigala
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California (UC), Davis, 2211 VM3B, Davis, CA 95616 USA
| | - Kimber L. Stanhope
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California (UC), Davis, 2211 VM3B, Davis, CA 95616 USA
- Basic Sciences, Touro University of California, Vallejo, CA USA
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32
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Tai DBG, Shah A, Doubeni CA, Sia IG, Wieland ML. The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States. Clin Infect Dis 2021; 72:703-706. [PMID: 32562416 PMCID: PMC7337626 DOI: 10.1093/cid/ciaa815] [Citation(s) in RCA: 757] [Impact Index Per Article: 252.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/15/2020] [Indexed: 12/19/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected racial and ethnic minority groups, with high rates of death in African American, Native American, and LatinX communities. Although the mechanisms of these disparities are being investigated, they can be conceived as arising from biomedical factors as well as social determinants of health. Minority groups are disproportionately affected by chronic medical conditions and lower access to healthcare that may portend worse COVID-19 outcomes. Furthermore, minority communities are more likely to experience living and working conditions that predispose them to worse outcomes. Underpinning these disparities are long-standing structural and societal factors that the COVID-19 pandemic has exposed. Clinicians can partner with patients and communities to reduce the short-term impact of COVID-19 disparities while advocating for structural change.
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Affiliation(s)
| | - Aditya Shah
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Chyke A Doubeni
- Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Irene G Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark L Wieland
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, Minnesota, USA.,Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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33
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Gilreath TD, Dangerfield DT, Montiel Ishino FA, Hill AV, Johnson RM. Polytobacco use among a nationally-representative sample of black high school students. BMC Public Health 2021; 21:206. [PMID: 33485321 PMCID: PMC7824955 DOI: 10.1186/s12889-021-10228-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods Latent class analysis (LCA) was used to identify patterns of adolescent polytobacco use among a representative sample of Black youth from the 2017 Youth Risk Behavior Survey (n = 2782). Ever and recent (past 30 day) use of cigarettes, electronic cigarettes, cigars, and dip or chewing tobacco were used as latent class indicators. Multinomial regression was conducted to identify the association if smoking adjusting for sex, age, grade, and marijuana use. Results Most students were in the 9th grade (29%), e-cigarette users (21%) and were current marijuana users (25%). Three profiles of tobacco use were identified: Class 1: Non-smokers (81%), Class 2: E-cigarette Users (14%), and Class 3: Polytobacco Users (5%). Black adolescent Polytobacco users were the smallest class, but had the highest conditional probabilities of recent cigarette use, e-cigarette use, ever smoking cigars or chewing tobacco. Ever and current use of marijuana were associated with increased odds of being in the e-cigarette user versus non-smoker group, and current marijuana use was associated with increased odds of polytobacco use (aOR = 24.61, CI = 6.95–87.11). Conclusions Findings suggests the need for targeted interventions for reducing tobacco use and examining the unique effects of polytobacco use on Black adolescents. Findings confirm a significant association of marijuana use with tobacco use.
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Affiliation(s)
- Tamika D Gilreath
- Department of Health & Kinesiology, College Station, Texas A & M University, 267 Gilchrist, 4243 TAMU, College station, TX, 77843-4243, USA.
| | | | - Francisco A Montiel Ishino
- Division of Intramural Research, National Institute for Minority Health Disparities, Bethesda, MD, 20892, USA
| | - Ashley V Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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34
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Fischer NM, Duffy EY, Michos ED. Protecting Our Youth: Support Policy to Combat Health Disparities Fueled by Targeted Food Advertising. J Am Heart Assoc 2021; 10:e018900. [PMID: 33375810 PMCID: PMC7955455 DOI: 10.1161/jaha.120.018900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Nicole M. Fischer
- Ciccarone Center for the Prevention of Cardiovascular DiseaseDivision of CardiologyJohns Hopkins University School of MedicineBaltimoreMD
| | - Eamon Y. Duffy
- Ciccarone Center for the Prevention of Cardiovascular DiseaseDivision of CardiologyJohns Hopkins University School of MedicineBaltimoreMD
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
| | - Erin D. Michos
- Ciccarone Center for the Prevention of Cardiovascular DiseaseDivision of CardiologyJohns Hopkins University School of MedicineBaltimoreMD
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
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35
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Lee JGL, Blanchflower TM, O'Brien KF, Cofie LE, Gregory KR, Averett PE. Assessing the Potential Impact of Cigarette Packs Designed for Lesbian, Gay, Bisexual, and Transgender Adults: A Randomized Experiment to Inform U.S. Regulation, 2018. Health Promot Pract 2020; 21:157S-164S. [PMID: 31908205 DOI: 10.1177/1524839919879923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Food and Drug Administration (FDA) can regulate the introduction of new tobacco products and some changes to existing products. Cigarette packs have been used as a marketing tool to target specific groups and priority populations. Research has shown that sexual and gender minority (SGM) adults are substantially more likely to use tobacco products than their straight and cisgender counterparts. However, research to inform the FDA's regulatory decisions regarding cigarette packs targeting priority populations is nascent. To fill this gap, we conducted an online experiment in 2018, randomizing U.S. adults who reported current smoking (N = 954, 52% were SGM) to view one of three cigarette packs. A graphic designer developed "Glacier" branded packs with three levels of SGM imagery: (1) no targeting, (2) subtle targeting, and (3) a rainbow "pride edition." Participants viewed and rated the pack using cognitive, affective, and behavioral measures informed by theory. We used a linear model framework to compare the two SGM-targeted packs with the not targeted version and tested interactions between pack and SGM identity for the dependent variables. We stratified results by SGM status. SGM status was a significant moderator of the relationship between the pack and ratings of appeal, positive affect, feeling shocked, and intent to try with a coupon. Findings from this study revealed that packs designed for SGM populations can disproportionately change cognitive, affective, and behavioral intention responses for SGM smokers. Products entering the market should be assessed by FDA for the appeal of their packs to vulnerable populations.
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Affiliation(s)
- Joseph G L Lee
- East Carolina University, Greenville, NC, USA.,UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
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36
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Hooked on Junk: Emerging Evidence on How Food Marketing Affects Adolescents’ Diets and Long-Term Health. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00346-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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Bleich SN, Soto MJ, Jones-Smith JC, Wolfson JA, Jarlenski MP, Dunn CG, Frelier JM, Herring BJ. Association of Chain Restaurant Advertising Spending With Obesity in US Adults. JAMA Netw Open 2020; 3:e2019519. [PMID: 33026451 PMCID: PMC7542328 DOI: 10.1001/jamanetworkopen.2020.19519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
IMPORTANCE Restaurants spend billions of dollars on marketing. However, little is known about the association between restaurant marketing and obesity risk in adults. OBJECTIVE To examine associations between changes in per capita county-level restaurant advertising spending over time and changes in objectively measured body mass index (BMI) for adult patients. DESIGN, SETTING, AND PARTICIPANTS This cohort study used regression models with county fixed effects to examine associations between changes in per capita county-level (370 counties across 44 states) restaurant advertising spending over time with changes in objectively measured body mass index (BMI) for US adult patients from 2013 to 2016. Different media types and restaurant types were analyzed together and separately. The cohort was derived from deidentified patient data obtained from athenahealth. The final analytic sample included 5 987 213 patients, and the analysis was conducted from March 2018 to November 2019. EXPOSURE Per capita county-level chain restaurant advertising spending. MAIN OUTCOMES AND MEASURES Individual-level mean BMI during the quarter. RESULTS The included individuals were generally older (37.1% older than 60 years), female (56.8%), and commercially insured (53.5%). For the full population of 29 285 920 person-quarters, there was no association between changes in all restaurant advertising per capita (all media types, all restaurants) and changes in BMI. However, restaurant advertising spending was positively associated with weight gain for patients in low-income counties but not in high-income counties. A $1 increase in quarterly advertising per capita across all media and restaurant types was associated with a 0.053-unit increase in BMI (95% CI, 0.001-0.102) for patients in low-income counties, corresponding to a 0.12% decrease in BMI at the 10th percentile of changes in county advertising spending vs a 0.12% increase in BMI at the 90th percentile. CONCLUSIONS AND RELEVANCE The results of this study suggest that restaurant advertising is associated with modest weight gain among adult patients in low-income counties. To date, there has been no public policy action or private sector action to limit adult exposure to unhealthy restaurant advertising. Efforts to decrease restaurant advertising in low-income communities should be intensified and rigorously evaluated to understand their potential for increasing health equity.
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Affiliation(s)
- Sara N. Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Mark J. Soto
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jesse C. Jones-Smith
- Department of Health Services, University of Washington School of Public Health, Seattle
| | - Julia A. Wolfson
- Department of Health Management and Policy, Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor
| | - Marian P. Jarlenski
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Caroline G. Dunn
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Johannah M. Frelier
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Bradley J. Herring
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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38
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Farley SM, Sisti J, Jasek J, Schroth KRJ. Flavored Tobacco Sales Prohibition (2009) and Noncigarette Tobacco Products in Retail Stores (2017), New York City. Am J Public Health 2020; 110:725-730. [PMID: 32191512 DOI: 10.2105/ajph.2019.305561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To assess explicit- (products clearly labeled flavored) and emergent concept- (products implying flavoring but not clearly labeled) flavored tobacco product availability following New York City's flavor restriction.Methods. We examined explicit- and concept-flavored tobacco product availability, with 2017 New York City Retailer Advertising of Tobacco Survey data (n = 1557 retailers). We assessed associations between block group-level demographic characteristics and product availability by using logistic regression.Results. Most retailers sold explicit-flavored (70.9%) or concept-flavored (69.3%) products. The proportion of non-Hispanic Black neighborhood residents predicted explicit- and concept-flavored product availability, as did having a high school within a retailer's block group for concept-flavored products.Conclusions. Explicit- and concept-flavored other tobacco products persisted throughout New York City, despite 2009 legislation restricting sales.Public Health Implications. Making local sales restrictions or federal production bans inclusive of all explicit and concept flavors would reduce retailer and industry evasion opportunities and protect the health of youths and others.
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Affiliation(s)
- Shannon M Farley
- All of the authors are from the New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, NY
| | - Julia Sisti
- All of the authors are from the New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, NY
| | - John Jasek
- All of the authors are from the New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, NY
| | - Kevin R J Schroth
- All of the authors are from the New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, NY
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Marijuana Promotion Online: an Investigation of Dispensary Practices. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:280-290. [PMID: 29629505 DOI: 10.1007/s11121-018-0889-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Marijuana product advertising will become more common, as the use of medical and/or recreational marijuana becomes increasingly legal in the USA. In this study, we investigate the marketing tactics being used on marijuana dispensary websites in the USA that could influence substance use behaviors. One hundred dispensary websites were randomly selected from 10 states that allowed the legal use of medical or recreational marijuana and had at least 10 operational dispensaries. Three dispensaries were excluded due to non-functioning websites, leaving a sample of 97 dispensaries. Content analysis was conducted on these dispensaries' websites, with the primary areas of focus including website age verification, marijuana effects, warnings, and promotional tactics. Among the 97 dispensaries, 75% did not include age verification. Roughly 30% offered online ordering and 21% offered delivery services. Sixty-seven percent made health claims pertaining to medical conditions that could be treated by their marijuana products, with moderate or conclusive evidence to support their claims. Less than half of the dispensaries (45%) advised consumers of possible side effects, and only 18% included warnings about contraindications. Nearly half (44%) offered reduced prices or coupons, 19% offered "buy one get one free" offers, and 16% provided giveaways or free samples. Our findings indicate that marijuana dispensary websites are easily accessible to youth. In addition, only a small amount of the websites advised consumers about possible side effects or contraindications. This study suggests the need for surveillance of marijuana commercialization and online advertising especially in the context of state policy reforms.
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Nguyen KH, Glantz SA, Palmer CN, Schmidt LA. Transferring Racial/Ethnic Marketing Strategies From Tobacco to Food Corporations: Philip Morris and Kraft General Foods. Am J Public Health 2020; 110:329-336. [PMID: 31944842 PMCID: PMC7002936 DOI: 10.2105/ajph.2019.305482] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To investigate the transfer of marketing knowledge and infrastructure for targeting racial/ethnic minorities from the tobacco to the food and beverage industry in the United States.Methods. We analyzed internal industry documents between April 2018 and April 2019 from the University of California San Francisco Truth Tobacco Industry Documents Library, triangulated with other sources.Results. In the 1980s, Philip Morris Companies purchased General Foods and Kraft Foods and created Kraft General Foods. Through centralized marketing initiatives, Philip Morris Companies directly transferred expertise, personnel, and resources from its tobacco to its food subsidiaries, creating a racial/ethnic minority-targeted food and beverage marketing program modeled on its successful cigarette program. When Philip Morris Companies sold Kraft General Foods in 2007, Kraft General Foods had a "fully integrated" minority marketing program that combined target marketing with racial/ethnic events promotion, racial/ethnic media outreach, and corporate donations to racial/ethnic leadership groups, making it a food industry leader.Conclusions. The tobacco industry directly transferred racial/ethnic minority marketing knowledge and infrastructure to food and beverage companies. Given the substantial growth of food and beverage corporations, their targeting of vulnerable populations, and obesity-related disparities, public policy and community action is needed to address corporate target marketing.
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Affiliation(s)
- Kim H Nguyen
- All of the authors are with the Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California San Francisco (UCSF), San Francisco
| | - Stanton A Glantz
- All of the authors are with the Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California San Francisco (UCSF), San Francisco
| | - Casey N Palmer
- All of the authors are with the Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California San Francisco (UCSF), San Francisco
| | - Laura A Schmidt
- All of the authors are with the Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California San Francisco (UCSF), San Francisco
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Fleming-Milici F, Harris JL. Adolescents’ engagement with unhealthy food and beverage brands on social media. Appetite 2020; 146:104501. [DOI: 10.1016/j.appet.2019.104501] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/06/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
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Harris JL. Targeted Food Marketing to Black and Hispanic Consumers: The Tobacco Playbook. Am J Public Health 2020; 110:271-272. [PMID: 32023097 PMCID: PMC7002963 DOI: 10.2105/ajph.2019.305518] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Jennifer L Harris
- Jennifer L. Harris is with the Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, and an independent consultant specializing in marketing and public health
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43
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Dowling EA, Roberts C, Adjoian T, Farley SM, Dannefer R. Disparities in Sugary Drink Advertising on New York City Streets. Am J Prev Med 2020; 58:e87-e95. [PMID: 31917059 DOI: 10.1016/j.amepre.2019.09.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Studies show that outdoor advertisements for unhealthy, consumable products are associated with increased intake and often target youth, low-income neighborhoods, and neighborhoods of color. Despite evidence that overconsumption of sugary drinks contributes to obesity and other chronic conditions, little is known specifically regarding the patterns of outdoor sugary drink advertising. METHODS The number of outdoor, street-level advertisements featuring sugary drinks was assessed in a random sample of retail-dense street segments (N=953) in low, medium, and high-poverty neighborhoods in each of New York City's 5 boroughs in 2015. Negative binomial regression was used to determine associations between sugary drink ad density, poverty level, and other census tract-level demographics (2009-2013 estimates) in each borough and New York City overall. Data were analyzed in 2017-2019. RESULTS In New York City and in 3 of 5 boroughs, sugary drink ad density was positively associated with increased percentages of black, non-Latino residents (New York City: incidence rate ratio=1.20, p<0.001; Bronx: incidence rate ratio=1.30, p=0.005; Brooklyn: incidence rate ratio=1.18, p<0.001; Manhattan: incidence rate ratio=1.20, p<0.05). Positive associations were also observed with poverty level in Brooklyn (low versus medium poverty: incidence rate ratio=2.16, p=0.09; low versus high poverty: incidence rate ratio=2.17, p=0.02) and Staten Island (low versus medium poverty: incidence rate ratio=3.27, p=0.03). CONCLUSIONS This study found a consistent positive association between the density of outdoor sugary drink advertisements and the presence of non-Latino black residents in New York City and, in some boroughs, evidence of a positive association with neighborhood poverty. These findings highlight the inequities where sugary drinks are advertised in New York City.
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Affiliation(s)
- Erin A Dowling
- Bronx Neighborhood Health Action Center, New York City Department of Health and Mental Hygiene, New York, New York.
| | - Calpurnyia Roberts
- Bronx Neighborhood Health Action Center, New York City Department of Health and Mental Hygiene, New York, New York
| | - Tamar Adjoian
- Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, New York, New York
| | - Shannon M Farley
- Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, New York, New York
| | - Rachel Dannefer
- Harlem Neighborhood Health Action Center, New York City Department of Health and Mental Hygiene, New York, New York
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Lee JGL, Shook-Sa BE, Gilbert J, Ranney LM, Goldstein AO, Boynton MH. Risk, Resilience, and Smoking in a National, Probability Sample of Sexual and Gender Minority Adults, 2017, USA. HEALTH EDUCATION & BEHAVIOR 2020; 47:272-283. [PMID: 31994418 DOI: 10.1177/1090198119893374] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. There are well-documented inequities in smoking between sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, and transgender [LGBT]) and straight and cisgender people. However, there is less information about risk for and resilience against smoking among SGM people. Such information is critical for understanding etiology and developing interventions. Aims. To conduct a within-group assessment of risks and resiliencies relating to smoking status. Method. In 2017, we conducted a cross-sectional telephone survey with a national, probability-based sample of SGM adults (N = 453). We assessed theory-informed risks (adverse childhood events, substance use-oriented social environment, mental distress, stigma, discrimination, social isolation, and identity concealment) and resiliencies (advertising skepticism, identity centrality, social support, and SGM community participation). We applied survey weights, standardized predictor variables, and fit logistic regression models predicting smoking status. We stratified by age and SGM identity. Results. Patterns of risk and resilience differ by age and identity. Effects were consistently in the same direction for all groups for participating in substance use-oriented social environments, pointing to a potential risk factor for all groups. Advertising skepticism and having people you can talk to about being LGBTQ were potential protective factors. Discussion. Intervention development should address risk and resilience that differs by SGM identity. Additionally, our findings suggest interventionists should consider theoretical frameworks beyond minority stress. Conclusion. While much of the literature has focused on the role of stress from stigma and discrimination in tobacco use, addressing social norms and bolstering protective factors may also be important in SGM-targeted interventions.
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Affiliation(s)
- Joseph G L Lee
- East Carolina University, Greenville, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Jeffrey Gilbert
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leah M Ranney
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adam O Goldstein
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Anderson A, Spray J. Beyond awareness: Towards a critically conscious health promotion for rheumatic fever in Aotearoa, New Zealand. Soc Sci Med 2020; 247:112798. [PMID: 32007766 DOI: 10.1016/j.socscimed.2020.112798] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 10/25/2022]
Abstract
Since 2014, the Rheumatic Fever Prevention Programme has targeted communities in Aotearoa, New Zealand affected by high rates of rheumatic fever (RF): namely, Māori and Pacific families. Initiated with the aim of reducing ethnic health disparities, the Health Promotion Agency attempted to use culturally appropriate approaches by engaging in consultative processes with Māori and Pacific communities and health leaders in developing the intervention. However, these consultations largely focused on evaluating strategies for reaching "priority" audiences with the message to get sore throats checked and on changing health-seeking behaviours. There was little regard for what the structural roots of RF in Aotearoa might suggest about equitable interventions, nor for the potentially harmful effects of the messages and their presentation. The concept of structural violence can be a useful analytical tool to critically evaluate such interventions which attempt to address health disparities but do not meaningfully attend to equity. Drawing on three ethnographic studies with: 1) Northland Māori families (Anderson et al., 2015); 2) North Island Māori and Pacific families (Anderson et al., 2017); and 3) Māori and Pacific children at a South Auckland school (Spray, 2020), we show how recategorising RF disparities as expressions of violence reveals how, despite including cultural consultation, interventions may still inequitably distribute responsibility. In particular, by responsibilising communities affected with the highest rates of RF, the intervention creates collateral damage of stigma, internalised blame, emotional suffering and hypervigilance that reproduces structural violence. We suggest that attending to how families experience public health messaging in the context of their daily lives may guide a more critical and culturally safe health promotion that looks beyond awareness and behaviour and towards equity.
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Affiliation(s)
- Anneka Anderson
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Julie Spray
- Anthropology, School of Social Sciences, Faculty of Arts, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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46
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Jamison AM, Broniatowski DA, Dredze M, Wood-Doughty Z, Khan D, Quinn SC. Vaccine-related advertising in the Facebook Ad Archive. Vaccine 2019; 38:512-520. [PMID: 31732327 DOI: 10.1016/j.vaccine.2019.10.066] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/26/2019] [Accepted: 10/23/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND In 2018, Facebook introduced Ad Archive as a platform to improve transparency in advertisements related to politics and "issues of national importance." Vaccine-related Facebook advertising is publicly available for the first time. After measles outbreaks in the US brought renewed attention to the possible role of Facebook advertising in the spread of vaccine-related misinformation, Facebook announced steps to limit vaccine-related misinformation. This study serves as a baseline of advertising before new policies went into effect. METHODS Using the keyword 'vaccine', we searched Ad Archive on December 13, 2018 and again on February 22, 2019. We exported data for 505 advertisements. A team of annotators sorted advertisements by content: pro-vaccine, anti-vaccine, not relevant. We also conducted a thematic analysis of major advertising themes. We ran Mann-Whitney U tests to compare ad performance metrics. RESULTS 309 advertisements were included in analysis with 163 (53%) pro-vaccine advertisements and 145 (47%) anti-vaccine advertisements. Despite a similar number of advertisements, the median number of ads per buyer was significantly higher for anti-vaccine ads. First time buyers are less likely to complete disclosure information and risk ad removal. Thematically, anti-vaccine advertising messages are relatively uniform and emphasize vaccine harms (55%). In contrast, pro-vaccine advertisements come from a diverse set of buyers (83 unique) with varied goals including promoting vaccination (49%), vaccine related philanthropy (15%), and vaccine related policy (14%). CONCLUSIONS A small set of anti-vaccine advertisement buyers have leveraged Facebook advertisements to reach targeted audiences. By deeming all vaccine-related content an issue of "national importance," Facebook has further the politicized vaccines. The implementation of a blanket disclosure policy also limits which ads can successfully run on Facebook. Improving transparency and limiting misinformation should not be separate goals. Public health communication efforts should consider the potential impact on Facebook users' vaccine attitudes and behaviors.
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Affiliation(s)
- Amelia M Jamison
- Center for Health Equity, 3302 School of Public Health Building, 4200 Valley Drive, University of Maryland, College Park, MD, USA.
| | - David A Broniatowski
- Department of Engineering Management & Systems Engineering, School of Engineering & Applied Sciences, George Washington University, Washington DC, USA
| | - Mark Dredze
- Computer Science Department, Johns Hopkins University, Baltimore, MD, USA
| | - Zach Wood-Doughty
- Computer Science Department, Johns Hopkins University, Baltimore, MD, USA
| | - DureAden Khan
- Center for Health Equity, 3302 School of Public Health Building, 4200 Valley Drive, University of Maryland, College Park, MD, USA
| | - Sandra Crouse Quinn
- Center for Health Equity, 3302 School of Public Health Building, 4200 Valley Drive, University of Maryland, College Park, MD, USA; Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
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Bragg MA, Miller AN, Kalkstein DA, Elbel B, Roberto CA. Evaluating the influence of racially targeted food and beverage advertisements on Black and White adolescents' perceptions and preferences. Appetite 2019; 140:41-49. [PMID: 31055011 PMCID: PMC9743992 DOI: 10.1016/j.appet.2019.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 03/31/2019] [Accepted: 05/01/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The present study measures how racially-targeted food and beverage ads affect adolescents' attitudes toward ads and brands, purchase intentions for advertised products, and willingness to engage with brands on social media. METHODS Black and White adolescents were recruited through Survey Sampling International in 2016. Participants completed an online survey in which they were randomized to view either four food and beverage ads (e.g., soda, candy commercials) featuring Black actors or four food and beverage ads featuring White actors. RESULTS For the two components of the attitudinal outcome, Black participants were more likely to report a positive affective response toward racially-similar ads compared to Whites. However, White participants were more likely to like ads that were racially-dissimilar compared to Black participants. Data were analyzed in 2016-2017, and we used an alpha level of 0.05 to denote statistical significance. CONCLUSIONS Both Black and White adolescents reported more positive affective responses to ads that featured Blacks compared to ads that featured Whites. Because there were no differences on two outcomes, future research should examine the influence of racially-targeted marketing in real-world contexts (e.g., social media) and longitudinal exposure to targeted advertising on dietary behavior.
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Affiliation(s)
- Marie A. Bragg
- Department of Population Health, New York University School of Medicine, 227 East 30thStreet, New York, NY, 10016, United States,College of Global Public Health, New York University, 726 Broadway, New York, NY, 10012, United States,Corresponding author. Department of Population Health, New York University School of Medicine, 227 East 30thStreet, New York, NY, 10016, United States. (M.A. Bragg)
| | - Alysa N. Miller
- Department of Population Health, New York University School of Medicine, 227 East 30thStreet, New York, NY, 10016, United States
| | - David A. Kalkstein
- Department of Psychology, Stanford University, 450 Serra Mall, Building 420, Stanford, CA, 2130, United States
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, 227 East 30thStreet, New York, NY, 10016, United States,New York University Wagner School of Public Service, 295 Lafayette St, New York, NY, 10012, United States
| | - Christina A. Roberto
- Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Mezzanine, Philadelphia, PA, 19104, United States
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Masterson TD, Stein WM, Beidler E, Bermudez M, English LK, Keller KL. Brain response to food brands correlates with increased intake from branded meals in children: an fMRI study. Brain Imaging Behav 2019; 13:1035-1048. [PMID: 29971684 PMCID: PMC7061688 DOI: 10.1007/s11682-018-9919-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Food branding is ubiquitous, however, not all children are equally susceptible to its effects. The objectives of this study were to 1) determine whether food brands evoke differential response than non-food brands in brain areas related to motivation and inhibitory control using blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and 2) determine the association between brain response and energy intake at test-meals presented with or without brands. Twenty-eight 7-10 year-old children completed four visits as part of a within-subjects design where they consumed three multi-item test-meals presented with familiar food brands, novel food brand, and no brand. On the fourth visit an fMRI was performed where children passively viewed food brands, non-food brands and control images. A whole-brain analysis was conducted to compare BOLD response between conditions. Pearson's correlations were calculated to determine the association between brain response and meal intake. Relative to non-food brands, food brand images were associated with increased activity in the right lingual gyrus. Relative to control, food and non-food brand images were associated with greater response in bilateral fusiform gyri and decreased response in the cuneus, precuneus, lingual gyrus, and supramarginal gyrus. Less activation in the bilateral fusiform gyrus to both food and non-food brands was associated with greater energy intake of the branded vs unbranded meal. These findings may help explain differences in the susceptibility to the intake-promoting effects of food advertising in children.
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Affiliation(s)
- Travis D Masterson
- Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Wendy M Stein
- Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Emma Beidler
- Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Maria Bermudez
- Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Laural K English
- Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kathleen L Keller
- Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
- Food Science, The Pennsylvania State University, University Park, 16802, PA, USA.
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Masterson TD, Gilbert-Diamond D, Lansigan RK, Kim SJ, Schiffelbein JE, Emond JA. Measurement of external food cue responsiveness in preschool-age children: Preliminary evidence for the use of the external food cue responsiveness scale. Appetite 2019; 139:119-126. [PMID: 31047939 PMCID: PMC6556134 DOI: 10.1016/j.appet.2019.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/28/2019] [Accepted: 04/28/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Conditioned eating in response to external food cues may contribute to obesity risk in young children. OBJECTIVES To develop a brief, parent-reported scale to measure external food cue responsiveness for preschool-age children. METHODS Focus groups with parents of preschool-age children were conducted to create an initial pool of items reflecting children's behavioral responses to external food cues. Items were included in a nationally-distributed online survey of parents of preschool-age children (n = 456). Factor analysis was used to reduce the initial item pool, the scale's psychometric properties were assessed, and scores were correlated with reported snacking behaviors. RESULTS Nine items met inclusion criteria in the final scale, which had high internal consistency (alpha = 0.86). Final scores were the mean across the nine items. External food cue responsiveness was greater among children with, versus without, usual TV advertisement exposure. Furthermore, greater external food cue responsiveness mediated the relationship between children's usual TV advertisement exposure and snacking during TV viewing. Findings remained statistically significant when adjusted for food responsiveness as measured with the Child Eating Behavior Questionnaire. CONCLUSIONS Findings provide preliminary evidence that external food cue responsiveness is measurable by parental report in preschool-age children.
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Affiliation(s)
- Travis D Masterson
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA; Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA.
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA; Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Reina K Lansigan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Sunny Jung Kim
- Department of Health Behavior and Policy, VCU Massey Cancer Center, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Jenna E Schiffelbein
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Jennifer A Emond
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA; Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
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Kumanyika SK. Unraveling common threads in obesity risk among racial/ethnic minority and migrant populations. Public Health 2019; 172:125-134. [PMID: 31227270 PMCID: PMC6698150 DOI: 10.1016/j.puhe.2019.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 04/22/2019] [Accepted: 04/28/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Epidemic obesity poses a major threat to global health. This phenomenon reflects the inability of the average person to cope, biologically and behaviorally, with environmental contexts that promote caloric overconsumption and inadequate caloric expenditure. There is still much to be learned about how to improve these contexts nationally and within-countries for sociodemographic groups with above-average obesity risks. METHODS Higher obesity risks relative to respective white majority populations were identified among diverse indigenous, other native-born, or migrant 'racial' or ethnic minority (hereafter, ethnic minority) populations in the United States, Canada, Australia, New Zealand, and the Netherlands, using publicly available national survey data or other sources. Cross-national comparisons were of interest for identifying common risk pathways associated with social and economic inequities. Potential explanations were explored through a narrative review of peer-reviewed literature, informed by the World Health Organization's Conceptual Framework for Action on The Social Determinants of Health. MAIN FINDINGS Identifying viable solutions to the high risk of obesity in ethnic minority populations in these high-income countries requires examination of national-level social, economic, and health system contexts, food systems, and built environments for physical activity, as well as patterns of social stratification and cultural biases related to ethnicity, migration, and other determinants of social disadvantage. These factors can be linked to mediators of exposure or vulnerability to obesity-related risks, such as poverty, being an 'outsider', stress and trauma resulting from historical and current oppression, exposure to bias and discrimination, related biological or behavioral consequences, and inadequate health and social care. CONCLUSIONS Focusing on ethnic minority populations in high-income countries is critical for public health efforts to address epidemic obesity. Mitigating intersecting risk pathways arising from stratification and bias based on ethnicity and migrant status should be prominent in these efforts.
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Affiliation(s)
- S K Kumanyika
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
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