Why is nutrition and health behaviour research needed? Consumer

Why is nutrition and health behaviour research needed? Consumer insight on choice, eating and drinking
Basel, 31 May 2012
Faculty Agricultural Sciences, Nutritional Sciences and Environmental Management
Department Nutrition Education & Consumer Behaviour
Centre for international Development and Environmental Research (ZEU)
Section Food & Nutrition Security
Ingrid‐Ute Leonhäuser
Overview
1. Problem Statements
2. Definition/Description
3. Psychological, Behavioural (Economics‐) Models and Models on food and nutrition
4. Methods (quantitative and qualitative)
5. Results/knowledge on behaviour on food, nutrition and health
6. Behavioural Modification Problem Statement
Reasons for nutritional and health behaviour research
• our health needs improvement
• dietary and physical activity patterns are not optimal
• complex food choice environment
• complex information environment
• consumer bewilderment, uncertainty and concern Reasons for justification
• information and knowledge but no behavioural change
• WHO concepts: prevention activities on behaviour and conditions
• Willingness of the EU consumer, nutrition and health policy
Dimensions of nutrition research in psycho‐social context
interpretation of behaviour:
eating habits
‐ cultural, social and individual
factors and meanings
analysis of behaviour:
- dietary records
eating behaviour
nutrition
‐ eating habits
‐ consumption data
‐ data of food industry
‐ research of consumer
behaviour
status of nutrition and health:
- nutritional physiology
‐ nutritional biochemistry
‐ nutritional medicine
Leonhäuser, 1998, modified according to C. von Ferber 1990
Definition
Food and nutrition behaviour
• Involves the selection and consumption of food and beverages,
• Is considering what, how, when where and with whom people eat,
• Plays an important role in symbolic, economic, and and social
aspects of life by expressing preferences, identities and cultural
meanings,
• Creates consumer demand,
• Determines which food and nutrients and other substances enter
the body,
• Influences health, morbidity and mortality. Sobal J, Bisogni C, Devine C M, and Jastran M (2006): A Conceptual Model of the Food Choice Process over
the Life Course. Shepherd R, Raats M (eds). The Psychology of Food Choice
Models – theoretical frameworks
1.
Model of Neobehaviourism
2.
Theory of Planned Behaviour
3.
Health Belief Model; Social Cognitive Model
4.
Determinants of Consumer‐ & Nutrition Behaviour
Methodological characteristics
of behavioural sciences
• interdisciplinary orientation
• empirical analysis
(behavioural scientific statements are proved
by confronting them with empiricism)
• methodological basic position
Ä Neobehaviourismus
Kroeber-Riel W et al. (2009): Konsumentenverhalten
S‐I‐R scheme to explain the consumer behaviour
observable
facts
Si (stimuli)
theoretical
constructs
Ii (intervening variable)
= psychological
processes
observable
facts
Rk (reactions)
(a) activating processes
ƒ emotion
ƒ motivation
ƒ attitude
(b) cognitive processes
Kroeber-Riel W, Weinberg P, Gröppel-Klein A (2009): Konsumentenverhalten. München: Vahlen
Comparison of quantitative and qualitative research
quantitative
qualitative
Research paradigm
Structur
Action
Human Experiences, Holistic
Design
Structured Design, Pretest/ Posttest Hypotheses
Research Process, Developing
Design and Research Question,
Methods
Sampling method
Experiment, Survey
Statistical
Observation, Interview, FGD
Theoretical
Question:
How many Xs? (enumeration)
What is X? (classification)
Reasoning:
Deductive
Inductive
Data analysis
Statistical analysis
Qualitative content‐analysis
Quality criteria
Objectivity, Reliability, Content completeness, Validity
Modified from: Vogelsang R: Einführung in das Thema Evaluation. Teil 2. Ernährungs-Umschau 43/4 (1996), S. 129; Bisogni
C, Sobal J (2008), p 25
Theory of Planned Behaviour
Attitude
Subjective Norm
Intention*
Behaviour
Perceived Behavioural
Control
Figure according to Ajzen / Madden 1986
The health action process approach.
Motivational Phase
Volitional Phase
Self‐Efficacy
Outcome
Expectancies
Risk
Perception
Goal/
Intention
Plan
Initiation
Maintenance
Recovery
Barriers and Resources
Contento IR (2011): Nutrition Education: Linking Rresearch, Theory, and Practice. Second Edition, p 105
Determinants of consumer‐ and nutritional behaviour
social change / change in values
public discussion
genetic factors
memory
learning
information
media /
advertisement
emotions
motivation
attitudes
market
supply
behavioural pattern
life cycle
- socio‐demographic variables (age, sex, social status, profession)
‐ household‐ and family type
‐ care system
Leonhäuser, I U (1995): Ernährungswissenschaft. In: Diedrichsen, I (Ed.) Humanernährung. Darmstadt: Steinkopff
Studies: Empirical Research Questions
•
Acceptance of New Nutrition Labelling by Consumers Aged 50 Plus – ANNA 50 +
•
Nutrition and Health Behaviour of Children in Low Income Families – NUTRILOW
•
Food Provisioning in German Families by Employed Mothers ‐ EVPRA
Acceptance of New Nutrition Labelling by Consumers Aged 50 Plus
ANNA 50+: Objectives
Investigates elderly consumers’ acceptance of GDA‐labelling • awareness
• understanding
• use
• Investigation of underlying factors influencing the evaluation of GDAs →
background variables for explaining differences in acceptance
• Segmentation of the study sample based on the acceptance‐level
• Development of recommendations for improvements of label‐format and educational programmes
Jansen, Leonhaeuser 2007, Jansen 2009
Examples
Methodology ‐ questionnaire
• quantitative investigation with 568 consumers aged 50 ‐ 84
• semi‐structured questionnaire: 36 items, regarding aspects of nutrition labelling
• focus on consumer acceptance of GDAs:
– awareness
– understanding
– use •
background variables:
–
–
–
–
–
–
–
current shopping behaviour, determinants of food choice
nutrition information behaviour nutritional knowledge usage frequency, reasons for (not) using involvement in nutrition and health issues
health status, diet and socio‐demographic characteristics
suggestions for future GDA improvements Jansen, Leonhaeuser 2007; Jansen 2009; Jansen, Banka, Leonhaeuser 2009
Results ‐ product attributes
n = 568
Importance of product attributes
convenience
brand
organic/ ecological
preparation
price
package
habits
health claims
storage life
Importance of nutrients
ingredients
n = 568
taste
salt
freshness
1
2
3
4
5
proteins
sugar
Wording: carbohydrates
cholesterol
To what extend are the following product attributes/nutrients important for your product choice? Please estimate: Important in particular is [product attribute]/[nutrient]. energy value
fatty acids
fat
fibres
minerals
Answer categories: (1) strongly disagree (2) slightly disagree (3) indifferent (4) slightly agree (5) strongly agree
vitamins
1
2
3
Jansen L (2010): Verbraucherakzeptanz der erweiterten GDA-Nährtwertkennzeichnung, Dissertation
4
5
Results ‐ self‐reported use of GDAs
• 34.7% already use GDAs while shopping or at home – reasons: “to remain healthy”, “to control body‐weight”
– frequency: “often” (50,8%)
– use “while shopping” (52,3%)
• 65,3% don’t use GDAs
– reasons: “lack of time while shopping”, “illegible information”
• data indicate differences in usage for: –
–
–
–
–
–
–
–
sex (p < 0.001, phi = 0.17)
age (p = 0.014, r = 0.19)
nutrition related diseases (p = 0.02, phi = 0.1)
keeping a diet (p < 0.001, phi = 0.2)
GDA awareness (p < 0.001, phi = 0.4)
subjective knowledge about nutrition information (p < 0.001, Exp(B) = 1.615)
involvement (p = 0.002, Exp(B) = 1,535)
importance of nutrition labelling (p < 0.001, Exp(B) = 1.883)
Jansen L (2010): Verbraucherakzeptanz der erweiterten GDA-Nährtwertkennzeichnung, Dissertation
Discussion & Conclusions
• follow‐up research! • general tendency of results is similar to outcomes of past or related
studies
→ nutrition knowledge, involvement/motivation/interest and age = key
factors for adaptability of GDAs
• GDAs could be a valuable tool to make consumers more aware of their
diet → based on interest/ motivation
• in some points GDAs are a problem for elderly consumers → but seen as a meaningful approach
• recommendations for educational programmes
• motivation of consumers to use extended nutrition labelling is crucial
• consider elderly consumers’ competences and abilities, always focussing
on improved quality of life
Borgmeier, Westenhoefer 2009; Eufic, MAPP 2009; FSA 2009; Grunert, Wills 2007; Jansen, Leonhaeuser 2007, Jansen
2009
Nutrition and Health Behaviour of Children in Low Income Families –
NUTRILOW Study‐Design
•
Duration: 2005 – 2007
•
Place of Data collection: Nuremberg, Germany
•
Participants:
Schools in deprived areas versus schools in non‐deprived areas Forth grade primary school children and their parents
– Target group:
Children from families with low Socioeconomic Status [SES]
– Comparison group:
Children from families with higher SES
•
Design: Cross‐sectional study with an innovative method to record food intake (including its validation)
Walter C (2011): Ernährungs- und Gesundheitsverhalten von Nürnberger Grundschulkindern vor dem
Hintergrund ihrer sozioökonomischen Situation, Dissertation
NUTRILOW objectives
• Health‐ and nutrition status • Health and nutrition behaviour of primary school children with regard to their socioeconomic background
• Relation of nutrition, health, physical activity and socio economic factors
• Conception and application of an innovative computer assisted instrument to record food intake • Formulating recommendations for innovative nutrition education programmes for the target group
Walter C (2011): Ernährungs- und Gesundheitsverhalten von Nürnberger Grundschulkindern vor dem Hintergrund ihrer
sozioökonomischen Situation, Dissertation
NUTRILOW Methods
• Telephone interviews with parents
• Pupils completed questionnaires at school
• Collection of anthropometric data Nutrition status &
behaviour
• Analysis of blood samples • Written and computer assisted dietary protocol Walter C (2011): Ernährungs- und Gesundheitsverhalten von Nürnberger Grundschulkindern vor dem
Hintergrund ihrer sozioökonomischen Situation, Dissertation
Results: Consumption of Food contributing to inappropriate Diet
100%
90%
5,4
24,3
10,4
9,1
18,9
80%
29,7
14,3
11,7
7,1
5,4
5,4
10,7
1,8
7,1
18,2
22,1
18,9
70%
21,6
60%
60,7
50%
71,4
61,0
40%
30%
64,9
54,1
51,4
89,3
61,0
43,2
20%
26,8
10%
10,8
0%
10,8
10,8
SoftFast
Meat
drinks Food
low SES
niedriger
SES
never
Nie
14,3
Softdrinks
7,8
Fast
Food
12,5
5,2
Meat
1,8
Softdrinks
middle SES
mittlerer
SES
Fast
Food
Meat
high SES
hoher
SES
not
every
day Tag once
a day ammore
once a day am Tag
Nicht
jeden
Einmal
TagthanMehrmals
low SES: n=37
middle SES: n= 77 high SES: n= 56 n=170
Walter C (2011): Ernährungs- und Gesundheitsverhalten von Nürnberger Grundschulkindern vor dem Hintergrund ihrer
sozioökonomischen Situation, Dissertation
Conclusions
• Low SES families need more external support from local networks to help them implementing healthier lifestyles in their daily routines.
• Setting orientated programmes in deprived areas should focus on “life‐
skills” in the context of health.
• In the course of establishing all‐day schools healthy school‐lunches should be provided for all children regardless of their parents’ income and their families’ social background.
• In all‐day schools where new curricula are set up health and nutrition education modules should be included.
• Pocket PC could be used as an innovative didactical medium for children’s nutrition education. Walter C (2011): Ernährungs- und Gesundheitsverhalten von Nürnberger Grundschulkindern vor dem Hintergrund ihrer
sozioökonomischen Situation, Dissertation
Food Provisioning in German Families by Employed Mothers ‐ EVPRA
RESEARCH CONTEXT
• 58 % of German mothers are gainfully employed
• Germany misses national school lunch programs in elementary and secondary schools
• Popularity of eating out & consuming convenience foods
• National Nutrition Survey II: 50 % of women, and 66 % of men
are overweight, with rising numbers for children/teenagers
• decline of traditional meal pattern and family food culture
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung
zwischen privatem und öffentlichem Raum.
OBJECTIVES
General objective:
• To develop an understanding of how employed mothers manage daily
familiy food provisioning
Specific objectives:
• to identify meal patterns: when, where and with whom meals are eaten
• to assess shopping, cooking, storaging, serving and cleaning habits
• to analyze and value the importance of institutional and public food offers
for family food provisioning
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung
zwischen privatem und öffentlichem Raum.
DEFINITION
Familiy food provisioning includes:
• shopping, storage, preparation, cooking, service and cleanup
• organization, coordination, planning and prioritizing of tasks, time and families´s eating schedules
practical tasks and mental activities
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung
zwischen privatem und öffentlichem Raum.
PRESUMPTIONS
Family food provisioning is determined through:
• familie´s resources, especially time and household income, mother´s employment status and the age of children;
• mother´s cultural norms, values, role perception, their every
day life competencies and nutritional knowledge as well as infrastructure and available networks;
• households internal processes of decision making and negotiation.
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung
zwischen privatem und öffentlichem Raum.
DATA COLLECTION & ANALYSE
• semistructured in‐depth
interviews with 48 employed mothers;
• pretested interviewguide
with open ended questions
• selection criteria: occupational group, full or
part time, age of children
• qualitative content analysis
• case studies
• empirical founded typology generation on the basis of two criterias: resource strength & meal pattern Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung zwischen
privatem und öffentlichem Raum.
TYPOLOGY OF FAMILY FOOD PROVISIONING
The career
orientated
networker
The family
orientated
traditionalists
The sacrificially The ambivalent The pragmatic
eating
self employed
provisioner
individualists
The
overstrained
lone fighter
The laid‐back
uncon‐
ventionalists
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung zwischen
privatem und öffentlichem Raum.
THE CAREER‐ORIENTED NETWORKER
sociodemography & resources
• families with children aged
from 1 to 15 years
• both parents full time employed
• mothers (graduate profession) with flexible working hours
• comprehensive networks
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung
zwischen privatem und öffentlichem Raum.
THE PRAGMATIC SELF‐EMPLOYED
sociodemography & resources
• families with children
aged 0 to 10 y • both parents full time
• high professional qualification & work load
• mothers are selfemployed with
self‐determined working hours
• high household income
• diverse private network
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung zwischen
privatem und öffentlichem Raum.
THE OVERSTRAINED LONE FIGHTER
sociodemography & resources
• families with children aged from
3 to 18 years
• both parents full time employed
• mothers & fathers with low status of education
• low qualified jobs, shiftwork, inflexible working hours
• low household income
• no private networks
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung
zwischen privatem und öffentlichem Raum.
CONCLUSION
• deep insight into family food provisioning practices is an important source of information for development of intervention programs aimed at specific groups;
• the everyday life circumstances & values and habits families need to be considered;
• German situation: to support reconcilability of work & family life innovative concepts for institutional catering at work and in schools are needed.
Leonhäuser I-U, Meier-Gräwe U, Möser A, Zander U, Köhler J (2009): Essalltag in Familien. Ernährungsversorgung
zwischen privatem und öffentlichem Raum.
Behavioural Modification
Preconditions:
• Reflection on behaviour, on circumstances and
living conditions;
• Analysis of behavioural determinants, capabilities and skills
(cognitive, socio‐economic, psychological, cultural);
• Analysis of the real situation; Campaigns and programs on communication:
• Community based
• audience oriented
Thank you for your attention