Search

Mass media campaigns can change attitudes and behaviours to improve population health. However, a key challenge is achieving share of voice in a complex and cluttered media environment. The aim of this study was to compare advertising expenditure on public health campaigns for obesity prevention (and related healthy eating and physical activity campaigns) with competing commercial categories of (a) sugary drinks, (b) artificially sweetened drinks and (c) diet/weight loss products and programmes. These commercial products may either undermine or dilute public health messages by directly contributing to poor health or confusing the public about the best ways to sustain a healthy lifestyle. Monthly estimates of advertising expenditure in Australian media (television, outdoor, cinema, radio, newspapers, magazines and digital) were obtained from Nielsen Media for 2016-18. Eligible public health advertising expenditure for the entire period (total AUD$27M) was vastly outweighed by the commercial categories of sugary drinks (AUD$129M) and diet/weight loss products and services (AUD$122M). Artificially sweetened drinks accounted for an additional AUD$23M of expenditure. These results highlight the need to rebalance the ratio of advertising to support public health in Australia through increased funding for obesity prevention and related campaigns, and critically, through government regulation to limit competing commercial advertising., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Purpose of Review: This article investigates the role of food and beverage sponsorship of sports in influencing dietary behaviour, and ultimately obesity, focusing on research published in the past 5 years. A systematic strategy was used to search the health science, social science and marketing databases to identify peer-reviewed literature on food and non-alcoholic beverage company sponsorship of sport published in English from 2015 to 2019., Recent Findings: Sixteen discrete studies were identified: six content analyses, two qualitative studies, four cross-sectional surveys and four experimental studies. Findings indicate sports sponsorship is widely used to promote unhealthy foods through professional and community sport, prompting increased awareness and preference for sponsor products. Most studies assessed self-reported responses to sponsorship, with a lack of behavioural data on food purchasing and consumption. Sports sponsorship by unhealthy food brands achieves vast population reach and exposure, promoting increased brand awareness and preference for sponsor products. Research is needed to improve our understanding of the relationship between food and beverage sponsorship and energy intake. Research evaluating the efficacy of strategies to reduce spectator's exposure to unhealthy sports sponsorship is also needed.

Food product health warnings have been proposed as a potential obesity prevention strategy. This study examined the effects of text-only and text-and-graphic, negatively and positively framed health warnings on dietary choice behavior. In a 2 × 5 mixed experimental design, 96 participants completed a dietary self-control task. After providing health and taste ratings of snack foods, participants completed a baseline measure of dietary self-control, operationalized as participants' frequency of choosing healthy but not tasty items and rejecting unhealthy yet tasty items to consume at the end of the experiment. Participants were then randomly assigned to one of five health warning groups and presented with 10 health warnings of a given form: text-based, negative framing; graphic, negative framing; text, positive framing; graphic, positive framing; or a no warning control. Participants then completed a second dietary decision making session to determine whether health warnings influenced dietary self-control. Linear mixed effects modeling revealed a significant interaction between health warning group and decision stage (pre- and post-health warning presentation) on dietary self-control. Negatively framed graphic health warnings promoted greater dietary self-control than other health warnings. Negatively framed text health warnings and positively framed graphic health warnings promoted greater dietary self-control than positively framed text health warnings and control images, which did not increase dietary self-control. Overall, HWs primed healthier dietary decision making behavior, with negatively framed graphic HWs being most effective. Health warnings have potential to become an important element of obesity prevention., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

This study explored adult's attitudes and reactions to a range of television advertisements (ads) promoting healthy weight, physical activity and healthy eating. Twenty-four focus groups (N = 179) were conducted in metropolitan and regional areas of the Australian states of Victoria, New South Wales (NSW) and Queensland, with participants segmented by sex, education (no tertiary, at least some tertiary) and life stage (young adults, parents). Each group was assigned to one of the three advertising streams - Weight, Activity, or Nutrition - where responses to five different ads were explored using semi-structured, moderator-led discussions. Discussion transcripts were qualitatively content analysed using a conventional approach. Four main themes were identified in participants' discussions about the ads' main messages - (i) Why is it a problem? (ii) Who is it a problem for? (iii) What should I do about it? (iv) How do I make the changes? Reactions varied by demographic factors and current weight and lifestyle status. Participants furthest from achieving public health recommendations for weight, diet and activity were motivated by 'what' and 'how' ads involving gentle persuasion and helpful hints. Participants who were closer to meeting these recommendations were motivated by 'why' ads featuring more graphic and emotive content and new information. Findings suggest a strategic approach is important for the development of public health ads promoting healthy weight and lifestyle, with consideration given to the specific communication goals and who the target audience is. This should help ensure an appropriate message is delivered to priority population subgroups in the most informative and motivating manner., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Mass media communications are an important component of comprehensive interventions to address population levels of overweight and obesity, yet we have little understanding of the effective characteristics of specific advertisements (ads) on this topic. This study aimed to quantitatively test audience reactions to existing adult-focused public health television ads addressing overweight and obesity to determine which ads have the highest levels of message acceptance, argument strength, personalised perceived effectiveness and negative emotional impact., Methods: 1116 Australian adults aged 21-55 years recruited from a national online panel participated in this web-based study. Quotas were applied to achieve even numbers of males and females, those aged 21-29 years and 30-55 years, and those with a healthy weight (BMI = 18.5-24.9) and overweight/obesity (BMI = 25+). Participants were randomly assigned to view and rate four of eight ads that varied in terms of message content (health consequences, supportive/encouraging or social norms/acceptability) and execution style (graphic, simulation/animation, positive or negative testimonial, or depicted scene)., Results: Toxic fat (a graphic, health consequences ad) was the top performing ad on all four outcome measures and was significantly more likely than the other ads tested to promote strong responses in terms of message acceptance, argument strength and negative emotional impact. Measure up (a negative testimonial, health consequences ad) performed comparably on personalised perceived effectiveness. Most ads produced stronger perceptions of personalised perceived effectiveness among participants with overweight/obesity compared to participants with healthy weight. Some ads were more likely to promote strong negative emotions among participants with overweight/obesity., Conclusions: Findings provide preliminary evidence of the most promising content and executional styles of ads that could be pursued as part of obesity prevention campaigns. Ads emphasising the negative health consequences of excess weight appear to elicit stronger cognitive and emotional responses from adults with overweight/obesity. However, careful pre-testing of these types of ads is needed prior to their inclusion in actual campaigns to ensure they do not have unintended negative impacts such as increased stigmatisation of vulnerable individuals and increased levels of body dissatisfaction and/or eating-disordered behaviour among at-risk population sub-groups.

Objective: To identify predictors of increased adiposity for different measures of adiposity., Design: Prospective cohort study, the Melbourne Collaborative Cohort Study (MCCS), with data at baseline (1990-1994) and wave 2 (2003-2007)., Setting: Participants recruited from the community., Subjects: Australian-born participants (n 5879) aged 40 to 69 years who were not current smokers and who were free from common chronic diseases at recruitment. At baseline and at wave 2, weight and waist circumference were measured; while demographic and lifestyle variables were obtained at baseline via structured interviews., Results: Participants who reported any recreational physical activity at baseline had lower weight and smaller waist circumference at wave 2 than those who did not, particularly for younger participants and for vigorous physical activity. Walking for leisure was not associated, and greater physical activity at work was associated, with greater adiposity measures at wave 2. A diet low in carbohydrates and fibre, but high in fat and protein, predicted greater weight and waist circumference at wave 2. Participants were less likely to have elevated weight or waist circumference at wave 2 if they consumed low to moderate amounts of alcohol., Conclusions: Our findings indicate that promoting vigorous physical activity, encouraging a diet high in carbohydrate and fibre but low in fat and protein, and limiting alcohol intake could be promising approaches for preventing obesity in middle-aged adults. Similar interventions should successfully address the management of both weight and waist circumference, as they were predicted by similar factors.

Background: To address concerns that healthy weight and lifestyle campaigns (HWLCs) could have unintended psychological or behavioral consequences, this study tested reactions to TV advertisements from two HWLCs--"LiveLighter"® (employs graphic health effects messaging) and "Swap It Don't Stop It" (employs animation and light-hearted messaging). Methods: An online between-subjects experiment tested reactions to one of five advertisements: "Toxic Fat"; "Sugary Drinks" (both from "LiveLighter"); "Become a Swapper"; "How to Swap It" (both from "Swap It"); and "HSBC Bank" (control) among 2,208 adults from Western Australia and Victoria, Australia. Responses assessed were cognitive and emotional reactions, behavioral intentions, internalized weight bias, antifat attitudes, self-esteem and body dissatisfaction. Results: The HWLC advertisements prompted favorable cognitive reactions and weak to neutral positive and negative emotional responses. HWLC advertisements promoted stronger intentions to engage in adaptive lifestyle behaviors compared with the control advertisement. Intention to engage in maladaptive behaviors (e.g., skipping meals) was low overall and did not differ by condition. Compared with the control condition, participants who saw "LiveLighter" "Sugary Drinks" showed weaker disagreement with antifat attitudes; however, mean antifat attitude scores were still at the low end of the scale. HWLC advertisements did not promote internalized weight bias, reduced self-esteem or body dissatisfaction compared with the control advertisement. Conclusions: Overall, HWLC advertisements performed favorably compared with the control advertisement and showed no clear evidence of adverse impacts. Findings suggest HWLC advertisements may not promote negative psychological and behavioral consequences and can continue to be used in obesity prevention efforts.

Issue addressed: The LiveLighter® healthy weight and lifestyle social marketing campaign, developed in Western Australia, employs graphic advertising to communicate negative health effects of overweight and motivate behaviour change. This study extends prior evidence of the effectiveness of the LiveLighter® campaign by evaluating its implementation in a new jurisdiction. Methods: A controlled cohort design was employed in intervention (Vic) and comparison states (SA), with and without campaign exposure. Population surveys conducted at baseline (BL) (n = 1000 each state), had 75% retention at follow‐up (FU) (Vic: n = 715; SA: n = 787). Results: Total campaign awareness was moderate (61.5%). Exposed respondents indicated the campaign was "believable" (91.0%), made a strong argument for reducing weight (87.3%), made them "stop and think" (70.1%), motivated action to reach/stay a healthy weight (59.1%) and was "relevant" (55.6%). The proportion of respondents indicating "toxic fat build up" was a health consequence of overweight increased significantly from BL to FU in Vic and to a lesser extent in SA (Vic:55.7% vs 75.9%; SA:58.1% vs 62.6%, interaction P <.001). The proportion indicating cancer is a health consequence of overweight increased significantly from BL to FU in Vic, but not in SA (Vic:77.1% vs 83.4%; SA:77.8% vs 78.1%, interaction P <.05). Conclusions: This study extends the evidence base for the LiveLighter® campaign. Sustained campaign activity with clear behavioural recommendations is required to translate improved knowledge into behaviour change. So what: Evidence‐based mass media campaigns can positively impact health behaviours to address the unsustainable increasing burdens of unhealthy weight, dietary risk and inadequate physical activity. A National Obesity Campaign is needed and LiveLighter® is a ready‐made, relevant Australian resource. [ABSTRACT FROM AUTHOR]

Objective: To explore parents' responses to sponsorship of children's sport by unhealthy food brands and two alternative pro-health sponsorship options.Design: Between-subjects online experiment with four sponsorship conditions: (i) non-food branding (control); (ii) unhealthy food branding; (iii) healthier food branding; (iv) public health nutrition campaign branding. Participants were shown a short video and a promotional flyer for a fictional junior sports programme, with sponsor content representing their assigned brand. Afterwards, participants were asked a series of questions assessing their brand awareness, brand attitudes and preference for food sponsor branded products.Setting: Australia.Participants: Australian parents (n 1331) of children aged 6-9 years.Results: Compared with the control condition, unhealthy food sponsorship promoted increased awareness, branded product preferences and favourable attitudes towards unhealthy food sponsor brands. Healthier food sponsorship promoted similar effects for healthier food sponsor brands, except there was no significant increase in positive attitudes towards these brands. Sponsorship by public health nutrition campaigns promoted more negative attitudes towards unhealthy food sponsor brands and increased preference for healthier food sponsor branded products. Overall, healthier food sponsors and public health campaign sponsors were perceived to have better programme-sponsor fit and to be more appropriate sponsors of children's sport than unhealthy food sponsors.Conclusions: Restrictions on unhealthy food sponsorship of children's sport are needed to prevent unhealthy food brands from exploiting junior sport sponsorship to enhance their appeal. Sponsorship of children's sport by healthier food brands or public health nutrition campaigns could help promote healthier food choices among parents. [ABSTRACT FROM AUTHOR]

Issue Addressed: Evaluation of the behavioural impact of Western Australia's LiveLighter healthy weight and lifestyle campaign focussed on decreasing consumption of sugar-sweetened beverages (SSBs) using graphic imagery, as well as monitoring unintended consequences.Methods: A cohort design with pre-campaign telephone survey of Western Australian adults aged 25-49 (Time 1 May/Jun 2013: N = 1504) undertaken and repeated following the campaign (Time 2 Aug/Sep 2013: N = 822).Results: Post-campaign awareness was 67% with respondents in low socio-economic areas most likely to report viewing the campaign frequently. There was evidence of reduced SSB intake from baseline to follow-up among frequent (4+/week) SSB consumers (22% cf. 16%; P = 0.003) and some evidence among overweight (BMI 25+) weekly SSB consumers (56% cf. 48%; P = 0.013). There was also some evidence consumption of sweet food decreased (3+/week: 53% cf. 48%; P = 0.035) while fruit, vegetable and fast food consumption remained stable. Knowledge of potential health consequences of SSBs increased (70% cf. 82%; P < 0.001) with no change in knowledge of potential health consequences of overweight generally (86% cf. 89%). Importantly, there was no increase in endorsement of overweight stereotypes.Conclusions: The LiveLighter "Sugary Drinks" campaign positively impacted adults' knowledge and behaviour with regard to SSB consumption in a pattern specific to the campaign messaging and without adverse impact on weight-related stereotypes. SO WHAT?: Findings support the use of mass media for healthy lifestyle change. They suggest the public are receptive to undertaking the campaign's simple concrete lifestyle recommendation and provide an indication of the campaign dose required to achieve positive behaviour change. [ABSTRACT FROM AUTHOR]

Highlights: [•] Kilojoules, with or without traffic lights, associated with lower energy selections. [•] Menu labelling is an equitable means of encouraging healthier fast food choices. [•] Traffic light labels used most in making selections, percent daily intake least. [•] Menu disclosure of energy-content has potential to yield population health benefits. [ABSTRACT FROM AUTHOR]