Co-production and the Commercial Determinants of Health: Producing a Video on Young People's Exposure to Unhealthy Food Marketing
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Abstract
In 2022, the World Health Organisation estimated that 39 million children globally were living with obesity, and it is estimated that by 2025, 167 million people (adults and children) will be susceptible to health problems associated with overweight or obesity. Marketing of unhealthy food products is designed to influence people to eat more of them, and some marketing materials are directed specifically at children and young people, resulting in changes to their eating habits that can contribute to overweight and obesity. Despite numerous calls for action to protect children and young people from the harmful impacts of food marketing, they continue to be exposed to sophisticated and persuasive marketing techniques. This study aimed to investigate young people’s exposure to and perceptions of unhealthy food advertising to co-produce an advocacy video aimed at young people and policymakers. The research that contributed to the co-design of the videos was conducted with 33 young people aged between 12 and 16 living in the Central Belt of Scotland. The research comprised four stages: workshops, photo elicitation, focus groups and video development. Young people reported being exposed to unhealthy food adverts every day and in numerous locations, including on outdoor billboards and posters, in shops and on social media. Many of the physical food adverts that young people saw were located near the restaurant they were advertising, tempting people to visit. Our findings highlight that young people feel overly exposed to unhealthy food advertising and they identified aspects of these adverts (e.g., colours, logos and slogans) that they felt influenced food purchasing choices for themselves and their peers. Many participants also noted that they rarely, if ever, saw marketing for healthy foods. These concerns were also reflected in participants’ contributions to the video production process. These findings suggest that young people support the need for stronger legislation in Scotland to reduce exposure to unhealthy food advertising, as well as the redesign of unhealthy food adverts, promotions, and packaging to be less eye-catching as this influences purchasing choices.
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References
2. Scottish Government. Tackling childhood obesity. https://www.gov.scot/news/tackling-childhood-obesity/. Published 2018. Updated 14 May 2018. Accessed 17 April 2024.
3. Birtwistle S, Deakin E, Wildman J, et al. The Scottish Health Survey 2022 – volume 1: main report. Scottish Government;2022.
4. Chung S. Growth and Puberty in Obese Children and Implications of Body Composition. J Obes Metab Syndr 2017;26(4):243-250. doi:10.7570/jomes.2017.26.4.243.
5. Lee BY, Bartsch SM, Mui Y, et al. A systems approach to obesity. Nutr Rev 2017;75(suppl 1):94-106. doi:10.1093/nutrit/nuw049.
6. Swinburn B, Sacks G, Vandevijvere S, et al. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles. Obes Rev 2013;14. doi:10.1111/obr.12087.
7. Global Nutrition. Global Nutrition Report: action on equity to end malnutrition. Bristol, UK2020.
8. Ertz M, Le Bouhart G. The Other Pandemic: A Conceptual Framework and Future Research Directions of Junk Food Marketing to Children and Childhood Obesity. JMK 2022;42(1):30-50. doi:10.1177/02761467211054354.
9. Taillie LS, Busey E, Stoltze FM, Dillman Carpentier FR. Governmental policies to reduce unhealthy food marketing to children. Nutr Rev 2019;77(11):787-816. doi:10.1093/nutrit/nuz021.
10. UK Government. Tackling obesity: empowering adults and children to live healthier lives. Department of Health and Social Care. https://www.gov.uk/government/publications/tackling-obesity-government-strategy/tackling-obesity-empowering-adults-and-children-to-live-healthier-lives [Accessed 27 Febraury 2021]. Published 2020. Accessed.
11. Sadeghirad B, Duhaney T, Motaghipisheh S, Campbell NR, Johnston BC. Influence of unhealthy food and beverage marketing on children's dietary intake and preference: a systematic review and meta-analysis of randomized trials. Obes Rev 2016;17(10):945-959. doi:10.1111/obr.12445.
12. Smith R, Kelly B, Yeatman H, Boyland E. Food Marketing Influences Children's Attitudes, Preferences and Consumption: A Systematic Critical Review. Nutr 2019;11(4). doi:10.3390/nu11040875.
13. Boyland EJ, Halford JC. Television advertising and branding. Effects on eating behaviour and food preferences in children. Appetite 2013;62:236-241. doi:10.1016/j.appet.2012.01.032.
14. Boyland EJ, Harrold JA, Kirkham TC, Halford JC. Persuasive techniques used in television advertisements to market foods to UK children. Appetite 2012;58(2):658-664. doi:10.1016/j.appet.2011.11.017.
15. Hastings G, Stead M, McDermott L, et al. Review of Research on the Effects of Food Promotion to Children: Final Report. Glasgow: Centre for Social Marketing, University of Strathclyde;2003.
16. Cairns G, Angus K, Hastings G. The extent, nature and effects of food promotion to children: a review of the evidence to December 2008. Geneva: World Health Organisation;2009.
17. Smith MJ, Vaczy C, Kellerman A, Tulloch L, Hilton S. Young people’s perceptions of and exposure to unhealthy food advertising in Scotland. Scotland, UK: Scottish Obesity Alliance;2024.
18. Hickey G, Brearley S, Coldham T, et al. Guidance on co-producing a research project. Southampton, UK INVOLVE;2018.
19. Boyland EJ, Nolan S, Kelly B, et al. Advertising as a cue to consume: a systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults. Am J Clin Nutr 2016;103(2):519-533. doi:10.3945/ajcn.115.120022.
20. Shirani F, Parkhill K, Butler C, et al. Asking about the future: methodological insights from energy biographies. Int J Soc Res Methodol 2016;19(4):429-444. doi:10.1080/13645579.2015.1029208.
21. Neale B. Generating Data in Qualitative Longitudinal Research: A methodological review. Timescapes;2017.
22. Croghan R, Griffin C, Hunter J, Phoenix A. Young people's constructions of self: Notes on the use and analysis of the photo-elicitation methods. Int J Soc Res 2008;11(4):345-356. doi:10.1080/13645570701605707.
23. Barker J, Smith F. What’s in focus? A critical discussion of photography, children and young people. 2012;15(2):91-103. doi:10.1080/13645579.2012.649406.
24. Zartler U, Richter R. My Family through the Lens. Photo Interviews with Children and Sensitive Aspects of Family Life. Child Soc 2014;28(1):42-54. doi:https://doi.org/10.1111/j.1099-0860.2012.00447.x.
25. Braun V, Clarke V. Thematic analysis. In: APA handbook of research methods in psychology, Vol 2: Research designs: Quantitative, qualitative, neuropsychological, and biological. Washington, D.C., USA: American Psychological Association; 2012:57-71.
26. Scottish Government. The Scottish Index of Multiple Deprivation 2020. https://www.gov.scot/collections/scottish-index-of-multiple-deprivation-2020/. Published 2020. Accessed 20 December, 2023.
27. Boyland EJ, Nolan S, Kelly B, et al. Advertising as a cue to consume: a systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults1,2. Am J Clin Nutr 2016;103(2):519-533. doi:10.3945/ajcn.115.120022.
28. Smits T, Vandebosch H, Neyens E, Boyland E. The Persuasiveness of Child-Targeted Endorsement Strategies: A Systematic Review. Annals of the International Communication Association 2015;39. doi:10.1080/23808985.2015.11679179.
29. Kraak VI, Story M. Influence of food companies' brand mascots and entertainment companies' cartoon media characters on children's diet and health: a systematic review and research needs. Obes Rev 2015;16(2):107-126. doi:10.1111/obr.12237.
30. Kelly B, King ML, Chapman Mnd K, et al. A hierarchy of unhealthy food promotion effects: identifying methodological approaches and knowledge gaps. Am J Public Health 2015;105(4):e86-95. doi:10.2105/ajph.2014.302476.
31. Boyland EJ, Whalen R. Food advertising to children and its effects on diet: review of recent prevalence and impact data. Pediatr Diabetes 2015;16(5):331-337. doi:10.1111/pedi.12278.
32. Kelly B, Bochynska K, Kornman K, Chapman K. Internet food marketing on popular children's websites and food product websites in Australia. Public Health Nutr 2008;11(11):1180-1187. doi:10.1017/s1368980008001778.
33. Weber K, Story M, Harnack L. Internet food marketing strategies aimed at children and adolescents: a content analysis of food and beverage brand web sites. J Am Diet Assoc 2006;106(9):1463-1466. doi:10.1016/j.jada.2006.06.014.
34. Signal LN, Stanley J, Smith M, et al. Children’s everyday exposure to food marketing: an objective analysis using wearable cameras. IJBNPA 2017;14(1):137. doi:10.1186/s12966-017-0570-3.
35. Chung A, Zorbas C, Riesenberg D, et al. Policies to restrict unhealthy food and beverage advertising in outdoor spaces and on publicly owned assets: A scoping review of the literature. Obes Rev 2022;23(2):e13386. doi:https://doi.org/10.1111/obr.13386.
36. Taillie LS, Reyes M, Colchero MA, Popkin B, Corvalán C. An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study. PLoS Med 2020;17(2):e1003015. doi:10.1371/journal.pmed.1003015.
37. Masterson TD, Stein WM, Beidler E, et al. Brain response to food brands correlates with increased intake from branded meals in children: an fMRI study. Brain Imaging Behav 2019;13(4):1035-1048. doi:10.1007/s11682-018-9919-8.
38. Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr 2019;22(5):936-941. doi:10.1017/s1368980018003762.
39. Mozaffarian D, Angell SY, Lang T, Rivera JA. Role of government policy in nutrition—barriers to and opportunities for healthier eating. BMJ 2018;361:k2426. doi:10.1136/bmj.k2426.
40. Thompson C, Clary C, Er V, et al. Media representations of opposition to the 'junk food advertising ban' on the Transport for London (TfL) network: A thematic content analysis of UK news and trade press. SSM Popul Health 2021;15:100828. doi:10.1016/j.ssmph.2021.100828.
41. UK Government. Health and Care Bill: advertising of less healthy food and drink. London, UK2022. https://www.gov.uk/government/publications/health-and-care-bill-factsheets/health-and-care-bill-advertising-of-less-healthy-food-and-drink