Citizen approval of nudging interventions promoting healthy eating: the role of intrusiveness and trustworthiness.

BACKGROUND: Nudging interventions have lately been widely adopted by policy makers to increase the welfare of society and to help citizens make better choices. Hence, it has become important to understand the conditions under which they are approved. While most research has looked into whether professionals approve of nudging interventions, surprisingly the opinion of the target group has been widely ignored. This study investigated citizens' level of approval of nudging in the realm of healthy eating promotion, as well as its boundary conditions. METHODS: Participants (N = 1441) from the US and seven European countries were probed for their level of approval of nudges. Moreover, we investigated whether these levels of approval were dependent on the level of intrusiveness of the nudge and on the type and trustworthiness of the source (policy makers, experts, industry) implementing the nudge. RESULTS: People revealed moderate to high levels of approval with nudging across all countries. Intrusiveness and nudging approval were negatively associated. Nudges implemented by experts received more approval than those by policy makers. In general, approval increased with the trustworthiness of the source. CONCLUSIONS: These results provide information for European and American policy makers considering using nudging in their policy repertoire.

Nudging at the checkout counter - A longitudinal study of the effect of a food repositioning nudge on healthy food choice.

Objective The current study is a longitudinal conceptual replication and aimed to investigate the effect of a food repositioning nudge on healthy food choice in a kiosk. Design During eight weeks, sales data were collected. The former four weeks formed the baseline phase and the latter four weeks formed the nudge phase where healthy food products were repositioned at the checkout counter display, while unhealthy alternatives remained available elsewhere in the store. Main Outcome Measures The main variable of interest was the proportion of healthy food products (selected to be repositioned) sold per day. Also exit interviews were administered to gather individual level data about purchases, and awareness and opinions of the nudge. Results Results showed that the proportion of selected healthy food products in total food sales was higher in all four nudge weeks than in all four baseline weeks. Individual level data showed that more customers had bought a selected healthy food product in the nudge phase and that customers generally approved of the nudge. Conclusion The current study strengthened the empirical evidence base of repositioning healthy food products as an effective and well-accepted nudge.

Consumers' choice-blindness to ingredient information.

Food manufacturers and policy makers have been tailoring food product ingredient information to consumers' self-reported preference for natural products and concerns over food additives. Yet, the influence of this ingredient information on consumers remains inconclusive. The current study aimed at examining the first step in such influence, which is consumers' attention to ingredient information on food product packaging. Employing the choice-blindness paradigm, the current study assessed whether participants would detect a covertly made change to the naturalness of ingredient list throughout a product evaluation procedure. Results revealed that only few consumers detected the change on the ingredient lists. Detection was improved when consumers were instructed to judge the naturalness of the product as compared to evaluating the product in general. These findings challenge consumers' self-reported use of ingredient lists as a source of information throughout product evaluations. While most consumers do not attend to ingredient information, this tendency can be slightly improved by prompting their consideration of naturalness. Future research should investigate the reasons for consumers' inattention to ingredient information and develop more effective strategies for conveying information to consumers.

Boosters, anyone? Exploring the added value of booster sessions in a self-management intervention.

The current study explored the benefits of adding booster sessions to a validated and successful self-management intervention for type 2 diabetes patients (i.e. Beyond Good Intentions). Although the addition of booster sessions to self-management interventions is often recommended, it has not been empirically established to what extent booster sessions are in fact appreciated by participants. Participants in the current study (N = 129) followed the Beyond Good Intentions program and were offered a series of three booster sessions at 1, 3 and 5 months afterwards. Primary outcome variables included participants' attendance and evaluations of the booster phase. In addition, self-management behavior was assessed at baseline (T1), after the initial phase (T2) and after the booster phase (T3). Results showed that more than one-fourth of participants who completed the initial phase dropped out during the booster phase, and those who did complete both phases evaluated the booster phase significantly less positive as compared to the initial phase. With regard to the behavioral outcomes, we replicated previous findings showing positive effects on all measures during the initial phase. The booster phase, however, did not result in further improvements. It was concluded that the added value of booster sessions was, at best, questionable.

The first taste is always with the eyes: a meta-analysis on the neural correlates of processing visual food cues.

Food selection is primarily guided by the visual system. Multiple functional neuro-imaging studies have examined the brain responses to visual food stimuli. However, the results of these studies are heterogeneous and there still is uncertainty about the core brain regions involved in the neural processing of viewing food pictures. The aims of the present study were to determine the concurrence in the brain regions activated in response to viewing pictures of food and to assess the modulating effects of hunger state and the food's energy content. We performed three Activation Likelihood Estimation (ALE) meta-analyses on data from healthy normal weight subjects in which we examined: 1) the contrast between viewing food and nonfood pictures (17 studies, 189 foci), 2) the modulation by hunger state (five studies, 48 foci) and 3) the modulation by energy content (seven studies, 86 foci). The most concurrent brain regions activated in response to viewing food pictures, both in terms of ALE values and the number of contributing experiments, were the bilateral posterior fusiform gyrus, the left lateral orbitofrontal cortex (OFC) and the left middle insula. Hunger modulated the response to food pictures in the right amygdala and left lateral OFC, and energy content modulated the response in the hypothalamus/ventral striatum. Overall, the concurrence between studies was moderate: at best 41% of the experiments contributed to the clusters for the contrast between food and nonfood. Therefore, future research should further elucidate the separate effects of methodological and physiological factors on between-study variations.

Environmental correlates of physical activity and dietary behaviours among young people: a systematic review of reviews.

An extensive body of research exists on environmental influences on weight-related behaviours in young people. Existing reviews aimed to synthesize this body of work, but generally focused on specific samples, behaviours or environmental influences and integration of findings is lacking. Hereto, we reviewed 18 reviews representing 671 unique studies, aiming to identify what environmental factors do and do not affect physical activity and dietary behaviours in children and adolescents. Eleven reviews focused exclusively on physical activity, six on diet, and one review focused on both physical activity and dietary behaviours with only small overlap in included studies. Physical activity was more consistently related to school and neighbourhood characteristics than to interpersonal and societal environments. In contrast, interpersonal factors played a pronounced role in dietary behaviours; no school, neighbourhood or societal factors were consistently related to dietary behaviours. This review of reviews adds to the literature by providing a comprehensive synthesis of factors related to physical activity and dietary behaviours that could be targeted in interventions. Moreover, by identifying factors that are unrelated to physical activity and dietary behaviours, this review may help to narrow the scope of future studies and environmental interventions.