Testing a first online intervention to reduce conformity to cyber aggression in messaging apps.

Early adolescents frequently use mobile messaging apps to communicate with peers. The popularity of such messaging apps has a critical drawback because it increases conformity to cyber aggression. Cyber aggression includes aggressive peer behaviors such as nasty comments, nonconsensual image sharing, and social exclusion, to which adolescents subsequently conform. Recent empirical research points to peer group norms and reduced accountability as two essential determinants of conformity to cyber aggression. Therefore, the current study aimed to counteract these two determinants in a 2 (peer group norms counteracted: yes, no) x 2 (reduced accountability counteracted: yes, no) design. We created four intervention conditions that addressed adolescents' deficits in information, motivation, and behavioral skills. Depending on the condition (peer group norms, reduced accountability, combination, or control), we first informed participants about the influence of the relevant determinant (e.g., peer group norms). Subsequently, participants performed a self-persuasion task and formulated implementation-intentions to increase their motivation and behavioral skills not to conform to cyber aggression. Effectiveness was tested with a messaging app paradigm and self-report among a sample of 377 adolescents (Mage = 12.99, SDage = 0.84; 53.6% boys). Factorial ANCOVAs revealed that none of the intervention conditions reduced conformity to cyber aggression. Moreover, individual differences in susceptibility to peer pressure or inhibitory control among adolescents did not moderate the expected relations. Therefore, there is no evidence that our intervention effectively reduces conformity to cyber aggression. The findings from this first intervention effort point to the complex relationship between theory and practice. Our findings warrant future research to develop potential intervention tools that could effectively reduce conformity to cyber aggression.

Effect of Source Type and Protective Message on the Critical Evaluation of News Messages on Facebook: Randomized Controlled Trial in the Netherlands.

BACKGROUND: Disinformation has become an increasing societal concern, especially due to the speed that news is shared in the digital era. In particular, disinformation in the health care sector can lead to serious casualties, as the current COVID-19 crisis clearly shows. OBJECTIVE: The main aim of this study was to experimentally examine the effects of information about the source and a protective warning message on users' critical evaluation of news items, as well as the perception of accuracy of the news item. METHODS: A 3 (unreliable vs reliable vs no identified source) × 2 (with protective message vs without) between-subject design was conducted among 307 participants (mean age 29 (SD 10.9] years). RESULTS: The results showed a significant effect of source information on critical evaluation. In addition, including a protective message did not significantly affect critical evaluation. The results showed no interaction between type of source and protective message on critical evaluation. CONCLUSIONS: Based on these results, it is questionable whether including protective messages to improve critical evaluation is a way to move forward and improve critical evaluation of health-related news items, although effective methodologies to tackle the spread of disinformation are highly needed. TRIAL REGISTRATION: ClinicalTrials.gov NCT05030883; https://clinicaltrials.gov/ct2/show/NCT05030883.

A Health Game Targeting Children's Implicit Attitudes and Snack Choices.

Objective: The present study investigated whether a health game can be used to affect children's implicit attitudes toward food (IAsTF) and subsequent snack choices. Materials and Methods: The health game used was based on an evaluative conditioning paradigm. The experiment followed a between-subjects design with two conditions (health game vs. control), N = 79 (12.42 years ±1.64, body mass index: 25.06 ± 7.40). IAsTF were assessed at baseline and postintervention using an implicit association test (IAT). Baseline IAT scores were used to categorize IAsTF as healthy (favoring fruits) versus unhealthy IAsTF (favoring chocolates). In addition, three digital snack choices were recorded. Results: No main effect of condition on posttest IAsTF was found. However, baseline IAsTF moderated the effect of condition on posttest IAsTF; participants with less healthy baseline IAsTF playing the health game had healthier posttest IAsTF compared to those playing the control game. Regarding the snack choices, participants playing the health game favored fruit over chocolate in one of the snack choices. Baseline IAsTF did not moderate the effect of condition on snack choices. Conclusion: Tentative support was found that health games can be used to improve IAsTF, in particular among participants with less healthy ones at baseline.

Comparison of food recommendations varying in sustainability: Impact on dietary intake and motivation to follow recommendations.

Food recommendations increasingly focus on sustainability in addition to nutritional value. By providing participants with standard versus sustainable (plant-based) dietary recommendations for 3 weeks, the present research tested the impact of recommendations on dietary compliance. Furthermore, predictors of food intake were tested across food categories. Participants in the sustainable diet condition complied less with recommendations as compared to those in the standard diet condition and were less motivated to continue complying after the intervention. Taste was the main predictor of intake across food categories. Together, this stresses the importance of considering factors stimulating consumers' compliance when formulating food recommendations.

Watching TV Cooking Programs: Effects on Actual Food Intake Among Children.

OBJECTIVE: To test the effects of a cooking program on healthy food decisions. DESIGN: An experimental between-subjects design with 3 conditions: healthy, unhealthy, and control. SETTING: Class settings in 5 different schools. PARTICIPANTS: One hundred twenty-five children between 10 and 12 years of age. INTERVENTIONS: Video clips of cooking program containing healthy foods versus cooking program containing unhealthy foods versus control program. MAIN OUTCOME MEASURES: Healthy versus unhealthy food choice. ANALYSIS: Logistic regression analysis, with the control condition as a reference in the first contrast test and the unhealthy food condition as a reference in the second contrast, to examine effects on food choice between conditions. RESULTS: Children who watched the cooking program with healthy foods had a higher probability of selecting healthy food than children who watched the cooking program with unhealthy foods (P = .027), or with the control condition (P = .039). CONCLUSIONS AND IMPLICATIONS: These findings indicated a priming effect of the foods the children were exposed to, showing that nutrition education guided by reactivity theory can be promising. Cooking programs may affect the food choices of children and could be an effective method in combination with other methods to improve their dietary intake.

Investigating the impact of a health game on implicit attitudes towards food and food choice behaviour of young adults.

Improving diets by stimulating fruit and vegetable consumption might be beneficial, in particular when they substitute energy-dense products. The aim of present study was to investigate whether a health game can be used to positively affect healthy implicit attitudes (IAs) towards food and subsequent food choice behaviour of young adults. A 2 (Time: baseline vs. post-test) x 2 (Condition: health game vs. control game) x 2 (Baseline IAs: healthy IAs vs. less healthy IAs) mixed-subjects design was used with 125 participants (age: M = 20.17, SD = 1.88). IAs towards food were assessed at baseline and post-test using an Implicit Association Test (IAT). Additionally, food choice behaviour was assessed after game play. At baseline, the majority of participants had healthy IAs (i.e., favouring fruit over chocolate snacks). At post-test, significantly less healthy IAs were observed in the control condition, while this reduction was not significant in the health game condition. Regarding food choice behaviour, participants with healthy baseline IAs were more likely to select fruit in the health game condition than participants with healthy baseline IAs in the control game condition. However, participants with less healthy baseline IAs were less likely to select fruit in the health game condition than in the control condition. We found tentative support that health games can be used to influence IAs towards food and positively affect food choice behaviour. However, this influence was only observed for those with healthy baseline IAs. The current version of the health game would primarily benefit those already healthy and could negatively affect those that need the intervention most, so modifications are recommendable.

User Statistics for an Online Health Game Targeted at Children.

OBJECTIVE: Given that many households in western countries nowadays have home access to the Internet, developing health-promoting online interventions has the potential to reach large audiences. Studies assessing usage data of online health interventions are important and relevant but, as of yet, scarce. The present study reviewed usage data from Monkey Do, an existing online health game developed specifically for children from 4 to 8 years old. In addition, the effect of advertising on usage was examined. MATERIALS AND METHODS: In an observational study, a web-based analysis program was used to examine usage data of all visits to the online health game for the first 31 months following the launch. We reported descriptives for usage data. We analyzed the relationship between advertising and usage with a Mann-Whitney U test, and used a Pearson's chi-square test to investigate the association between advertising and the number of first-time visitors. RESULTS: In the period of data analysis, there were 224,859 sessions. Around 34% of the visitors played the game more than once. Compared with first-time visitors, the average session time of returning visitors was doubled. The game was most frequently accessed via search engine query, on a desktop computer (compared to mobile devices). Advertising was found to be positively related to the number of sessions and the number of first-time visitors. CONCLUSIONS: Placing a game online can reach a large audience, but it is important to also consider how to stimulate retention. Furthermore, repeated advertisement for an online game appears to be necessary to maintain visitors over time.

Memorizing fruit: The effect of a fruit memory-game on children's fruit intake.

Food cues of palatable food are omnipresent, thereby simulating the intake of unhealthy snack food among children. As a consequence, this might lead to a higher intake of energy-dense snacks and less fruit and vegetables, a habit that increases the risk of developing chronic diseases. The aim of this experimental study is to examine whether playing a memory game with fruit affects fruit intake among young children. We used a randomized between-subject design with 127 children (age: 7-12 y) who played a memory-game, containing either fruit (n = 64) or non-food products (n = 63). While playing the memory-game in a separate room in school during school hours, free intake of fruit (mandarins, apples, bananas, and grapes) was measured. Afterwards, the children completed self-report measures, and length and weight were assessed. The main finding is that playing a memory-game containing fruit increases overall fruit intake (P = 0.016). Children who played the fruit version of the memory-game ate more bananas (P = 0.015) and mandarins (P = 0.036) than children who played the non-food memory-game; no effects were found for apples (P > 0.05) and grapes (P > 0.05). The findings suggest that playing a memory-game with fruit stimulates fruit intake among young children. This is an important finding because children eat insufficient fruit, according to international standards, and more traditional health interventions have limited success. Healthy eating habits of children maintain when they become adults, making it important to stimulate fruit intake among children in an enjoyable way. TRIAL REGISTRATION: Nederlands Trial Register TC = 5687.

The association between BMI development among young children and (un)healthy food choices in response to food advertisements: a longitudinal study.

BACKGROUND: Previous studies have focused on the acute effects of food advertisements on the caloric intake of children; however, the long-term effects of this food cue reactivity on weight gain have not been examined. The main aim of this study was to explore if reactivity to food cues in an advertisement was associated with weight status two years later. METHODS: Children wo had previously taken part in an experiment investigating the impact of advergames on food intake had their height and weight re-measured two years later, for assessment of body mass index (BMI). A within-subject design was used to test the associations between food choices and BMI over time. In the previous experiment, children played an advergame that promoted energy-dense snacks, fruit, or nonfood products, or did not play an advergame (control condition). After playing the game, the free intake of energy-dense snacks and fruits was measured. RESULTS: Children who ate more apple after playing an advergame promoting energy-dense snacks had a lower BMI two years later. Consumption of energy-dense snacks after playing an advergame promoting energy-dense snacks was not associated with BMI two years later. In other condition, no association was found between food intake and BMI after two years . CONCLUSIONS: The findings suggest that coping with environmental cues that trigger unhealthy eating behavior is associated with the body mass index of young children two years later. This might imply that learning to respond to food cues by choosing healthy options might prevent children from excessive weight gain. This trial was registered at as ISRCTN17013832 .

The role of attentional bias in the effect of food advertising on actual food intake among children.

This study examined the potential moderating role of attentional bias (i.e., gaze duration, number of fixations, latency of initial fixation) in the effect of advergames promoting energy-dense snacks on children's snack intake. A randomized between-subject design was conducted with 92 children who played an advergame that promoted either energy-dense snacks or nonfood products. Eye movements and reaction times to food and nonfood cues were recorded to assess attentional bias during playtime using eye-tracking methods. Children could eat freely after playing the game. The results showed that playing an advergame containing food cues increased total intake. Furthermore, children with a higher gaze duration for the food cues ate more of the advertised snacks. In addition, children with a faster latency of initial fixation to the food cues ate more in total and ate more of the advertised snacks. The number of fixations on the food cues did not increase actual snack intake. Food advertisements are designed to grab attention, and this study shows that the extent to which a child's attention is directed to a food cue increases the effect of the advertisement.

Impulsivity, "advergames," and food intake.

BACKGROUND AND OBJECTIVES: Previous studies have focused on the effect of food advertisements on the caloric intake of children. However, the role of individual susceptibility in this effect is unclear. The aim of this study was to examine the role of impulsivity in the effect of advergames that promote energy-dense snacks on children's snack intake. METHODS: First, impulsivity scores were assessed with a computer task. Then a randomized between-subject design was conducted with 261 children aged 7 to 10 years who played an advergame promoting either energy-dense snacks or nonfood products. As an extra manipulation, half of the children in each condition were rewarded for refraining from eating, the other half were not. Children could eat freely while playing the game. Food intake was measured. The children then completed questionnaire measures, and were weighed and measured. RESULTS: Overall, playing an advergame containing food cues increased general caloric intake. Furthermore, rewarding children to refrain from eating decreased their caloric intake. Finally, rewarding impulsive children to refrain from eating had no influence when they were playing an advergame promoting energy-dense snacks, whereas it did lead to reduced intake among low impulsive children and children who played nonfood advergames. CONCLUSIONS: Playing an advergame promoting energy-dense snacks contributes to increased caloric intake in children. The advergame promoting energy-dense snacks overruled the inhibition task to refrain from eating among impulsive children, making it more difficult for them to refrain from eating. The findings suggest that impulsivity plays an important role in susceptibility to food advertisements.

The effect of positive and negative movie alcohol portrayals on transportation and attitude toward the movie.

BACKGROUND: This study examined the effects of alcohol portrayals on transportation and attitude toward a movie. In addition, we examined whether positive and negative movie alcohol portrayals affect transportation into and attitude toward the movie. METHODS: A within-subject design was used in which participants were exposed to 8 different movie clips containing alcohol (positive or negative context) or no alcohol portrayals in a controlled laboratory setting. A total of 159 college students (84 males and 75 females) ages 18 to 30 participated in the experiment. Transportation and attitude toward the movie were measured after each movie clip. RESULTS: Participants were more transported into and had a more positive attitude toward movie clips with alcohol portrayals compared to the same movie clips with no alcohol portrayal. In addition, participants were more transported into movie clips with negative alcohol (NA) portrayals compared to clips with positive alcohol (PA) portrayals. For attitude toward the movie, opposite results were found. Participants had a more positive attitudes toward clips with PA portrayals compared to clips with NA portrayals. CONCLUSIONS: The way alcohol is portrayed in movies may contribute to how people evaluate and get transported in movies.

Self-control and the effects of movie alcohol portrayals on immediate alcohol consumption in male college students.

BACKGROUND: In movies, alcohol-related cues are frequently depicted and there is evidence for a link between movie alcohol cues and immediate alcohol consumption. Less is known about factors influencing immediate effects movie alcohol exposure on drinking. The exertion of self-control is thought to be important in avoiding or resisting certain temptations. AIMS: The aim of the present study was to assess the immediate effects of movie alcohol portrayals on drinking of male social drinkers and to assess the moderating role of self-control in this relation. It was hypothesized that participants would drink more when exposed to movie alcohol portrayals and that especially participants with low self-control would be affected by these portrayals. METHODS: A between-subjects design comparing two movie conditions (alcohol or no portrayal of alcohol) was used, in which 154 pairs of male friends (ages 18-30) watched a 1-h movie in a semi-naturalistic living room setting. Their alcohol consumption while watching was examined. Participants completed a questionnaire assessing self-control as well as their self-reported weekly alcohol use. A multivariate regression analysis was conducted to test the effects of movie condition on alcohol comsumption. RESULTS: Self-control moderated the relation between movie condition and alcohol consumption. Assignment to the alcohol movie condition increased alcohol consumption during the movie for males with high self-control but not for males with low self-control. CONCLUSION: Viewing a movie with alcohol portrayals can lead to higher alcohol consumption in a specific sample of young men while watching a movie.

The role of explicit and implicit self-esteem in peer modeling of palatable food intake: a study on social media interaction among youngsters.

OBJECTIVE: This experimental study investigated the impact of peers on palatable food intake of youngsters within a social media setting. To determine whether this effect was moderated by self-esteem, the present study examined the roles of global explicit self-esteem (ESE), body esteem (BE) and implicit self-esteem (ISE). METHODS: Participants (N = 118; 38.1% boys; M age 11.14±.79) were asked to play a computer game while they believed to interact online with a same-sex normal-weight remote confederate (i.e., instructed peer) who ate either nothing, a small or large amount of candy. RESULTS: Participants modeled the candy intake of peers via a social media interaction, but this was qualified by their self-esteem. Participants with higher ISE adjusted their candy intake to that of a peer more closely than those with lower ISE when the confederate ate nothing compared to when eating a modest (ß = .26, p = .05) or considerable amount of candy (kcal) (ß = .32, p = .001). In contrast, participants with lower BE modeled peer intake more than those with higher BE when eating nothing compared to a considerable amount of candy (kcal) (ß = .21, p = .02); ESE did not moderate social modeling behavior. In addition, participants with higher discrepant or "damaged" self-esteem (i.e., high ISE and low ESE) modeled peer intake more when the peer ate nothing or a modest amount compared to a substantial amount of candy (kcal) (ß = -.24, p = .004; ß = -.26, p<.0001, respectively). CONCLUSION: Youngsters conform to the amount of palatable food eaten by peers through social media interaction. Those with lower body esteem or damaged self-esteem may be more at risk to peer influences on food intake.

Television watching and the emotional impact on social modeling of food intake among children.

The main goal of this study was to test whether exposure to happy, neutral, or sad media content influences social modeling effects of (snack) food intake in young children. The study was conducted at 14 Dutch urban and suburban primary schools. The participants (N=112) were asked to watch a movie with a same-sex normal-weight confederate who was instructed to eat either nothing or a standardized amount of snack food (10 chocolate-coated peanuts). The study involved a 3 (movie clips: happy, neutral, and sad)×2 (peer's food intake: no intake versus a standardized intake) between-participants design. A significant interaction between the movie clip condition and intake condition was found (F(2,102)=3.30, P=.04, Cohen's f(2)=.20). Positive as well as negative emotions were found to lead to adjustment to the intake of a peer, as compared to that of children in the neutral movie condition. The findings suggest that children eat more mindlessly when watching an emotional movie and, therefore, respond more automatically to a peer's food intake, whereas children may be less susceptible to a peer's intake while watching a neutral movie. As young children are not in the position to choose their food consumption environment yet, parents and schools should provide consumption settings that limit eating in front of the television.

The effect of playing advergames that promote energy-dense snacks or fruit on actual food intake among children.

BACKGROUND: Previous studies have focused on the effects of television advertising on the energy intake of children. However, the rapidly changing food-marketing landscape requires research to measure the effects of nontraditional forms of marketing on the health-related behaviors of children. OBJECTIVES: The main aim of this study was to examine the effect of advergames that promote energy-dense snacks or fruit on children's ad libitum snack and fruit consumption and to examine whether this consumption differed according to brand and product type (energy-dense snacks and fruit). The second aim was to examine whether advergames can stimulate fruit intake. DESIGN: We used a randomized between-subject design with 270 children (age: 8-10 y) who played an advergame that promoted energy-dense snacks (n = 69), fruit (n = 67), or nonfood products (n = 65) or were in the control condition (n = 69). Subsequently, we measured the free intake of energy-dense snacks and fruit. The children then completed questionnaire measures, and we weighed and measured them. RESULTS: The main finding was that playing an advergame containing food cues increased general energy intake, regardless of the advertised brand or product type (energy-dense snacks or fruit), and this activity particularly increased the intake of energy-dense snack foods. Children who played the fruit version of the advergame did not eat significantly more fruit than did those in the other groups. CONCLUSION: The findings suggest that playing advergames that promote food, including either energy-dense snacks or fruit, increases energy intake in children.

Imitation of snack food intake among normal-weight and overweight children.

This study investigated whether social modeling of palatable food intake might partially be explained by the direct imitation of a peer reaching for snack food and further, assessed the role of the children's own weight status on their likelihood of imitation during the social interaction. Real-time observations during a 10-min play situation in which 68 participants (27.9% overweight) interacted with normal-weight confederates (instructed peers) were conducted. Children's imitated and non-imitated responses to the confederate's food picking movements were compared using a paired sample t-test. In addition, the pattern of likelihood of imitation was tested using multilevel proportional hazard models in a survival analysis framework. Children were more likely to eat after observing a peer reaching for snack food than without such a cue [t (67) = 5.69, P < 0.0001]. Moreover, findings suggest that children may display different imitation responses during a social interaction based on their weight status (HR = 2.6, P = 0.03, 95% CI = 1.09-6.20). Overweight children were almost twice as likely to imitate, whereas normal-weight children had a smaller chance to imitate at the end of the interaction. Further, the mean difference in the likelihood of imitation suggest that overweight children might be less likely to imitate in the beginning of the interaction than normal-weight children. The findings provide preliminary evidence that children's imitation food picking movements may partly contribute to social modeling effects on palatable food intake. That is, a peer reaching for food is likely to trigger children's snack intake. However, the influence of others on food intake is a complex process that might be explained by different theoretical perspectives.

Alcohol portrayals in movies, music videos and soap operas and alcohol use of young people: current status and future challenges.

AIMS: To provide an overview of studies of the effects of alcohol portrayals in movies, music videos and soap operas on alcohol consumption among young people. Moreover, we highlight important issues that need to be addressed in future research. METHODS: This paper reviews the current literature on alcohol portrayals on-screen and the associated gaps and challenges in alcohol media research. RESULTS: Thirteen longitudinal studies, 8 cross-sectional studies and 6 experimental studies examined the effects of alcohol portrayals on-screen on alcohol consumption among young people. They showed a relation between on-screen alcohol exposure and onset and progression of alcohol consumption. A distinction can be made between long-term effects and immediate effects on alcohol consumption. Only lately, more attention has been paid to processes underlying the effects of on-screen alcohol exposure. CONCLUSION: Replication of findings and development of new research designs is essential. On-screen alcohol exposure does not affect everyone. It is important to test individual differences in susceptibility to on-screen alcohol portrayals. Further, not all media alcohol portrayal might provoke similar effects. It is therefore essential to test the effect of different types of alcohol portrayals.

Increased body satisfaction after exposure to thin ideal children's television in young girls showing thin ideal internalisation.

This study tested the direct effect of watching thin ideal children's television on body satisfaction in preadolescent girls (6-8 years old). A within-subject design was used in which girls (N = 51) were tested three times. They watched television clips in random order containing either (1) thin ideal animated characters or (2) animated characters with no thin ideal features or (3) 'real' human actors with no thin ideal features. After watching, their state body satisfaction was measured. Girls with higher levels of thin ideal internalisation showed higher body satisfaction after exposure to the thin ideal characters than after exposure to animated or real characters featuring no thin ideal features. No differences on body satisfaction between the exposure conditions were found in girls with lower levels of thin ideal internalisation. The results might suggest that young girls who internalised the thin ideal are inspired by thin ideal characters in children's media.