Explaining the effects of a point-of-purchase nutrition-information intervention in university canteens: a structural equation modelling analysis

Christine Hoefkens, Zuzanna Pieniak, John Van Camp, Wim Verbeke, Christine Hoefkens, Zuzanna Pieniak, John Van Camp, Wim Verbeke

Abstract

Background: The importance of canteen meals in the diet of many university students makes the provision of simple point-of-purchase (POP) nutrition information in university canteens a potentially effective way to promote healthier diets in an important group of young adults. However, modifications to environments such as the posting of POP nutrition information in canteens may not cause an immediate change in meal choices and nutrient intakes. The present study aimed at understanding the process by which the POP nutrition information achieved its effects on the meal choice and energy intake, and whether the information was more effective in changing the meal choice of subgroups of university canteen customers.

Methods: The POP nutrition-information intervention used a one-group pretest-posttest design. A sample of 224 customers of two university canteens completed the baseline and 6-months follow-up surveys. A multi-group structural equation modelling analysis was used to test mediation effects of individual difference variables (liking, understanding and use of the information, subjective knowledge and attitude) on the energy intake from canteen meals, moderated by the objective nutrition knowledge and motivation to change diet.

Results: Significant relations were identified between liking of the information and its use on one hand and a positive effect in attitude towards healthy canteen meals on the other hand. Motivation to change diet and sufficient objective nutrition knowledge were required to maintain a recommended energy intake from canteen meals or to lead to a decrease in energy intake. Participants with greater objective nutrition knowledge had a greater understanding of the POP nutrition information which also resulted in a more effective use of the information.

Conclusions: The results suggest that nutrition-information interventions may be more effective when using nutrition information that is generally liked by the target population in combination with an educational intervention to increase objective nutrition knowledge.

Trial registration: ClinicalTrials.gov NCT01249508.

Figures

Figure 1
Figure 1
Hypothetical model of the process by which the nutrition information achieves its effects on the meal choice and energy intake.

References

    1. Brunt AR, Rhee YS. Obesity and lifestyle in US college students related to living arrangemeents. Appetite. 2008;51:615–621. doi: 10.1016/j.appet.2008.04.019.
    1. Levitsky DA, Halbmaier CA, Mrdjenovic G. The freshman weight gain: a model for the study of the epidemic of obesity. Int J Obes (Lond) 2004;28:1435–1442. doi: 10.1038/sj.ijo.0802776.
    1. Nelson MC, Story M, Larson NI, Neumark-Sztainer D, Lytle LA. Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change. Obesity (Silver Spring) 2008;16:2205–2211. doi: 10.1038/oby.2008.365.
    1. Winkleby MA, Cubbin C. Changing patterns in health behaviors and risk factors related to chronic diseases, 1990–2000. Am J Health Promot. 2004;19:19–27. doi: 10.4278/0890-1171-19.1.19.
    1. CMM UGent. Rapport enquête studentenrestaurants Universiteit Gent [Report survey student restaurants Ghent University] Committee Marketing and Menu of the student restaurant of Ghent University, Ghent; 2009.
    1. Burton S, Creyer EH, Kees J, Huggins K. Attacking the obesity epidemic: The potential health benefits of providing nutrition information in restaurants. Am J Public Health. 2006;96:1669–1675. doi: 10.2105/AJPH.2004.054973.
    1. Kjollesdal MR, Holmboe-Ottesen G, Wandel M. Frequent use of staff canteens is associated with unhealthy dietary habits and obesity in a Norwegian adult population. Publ Health Nutr. 2011;14:133–141. doi: 10.1017/S1368980010001473.
    1. Lachat CK, Huybregts LF, Roberfroid DA, Van Camp J, Remaut-De Winter AME, Debruyne P, Kolsteren PW. Nutritional profile of foods offered and consumed in a Belgian university canteen. Publ Health Nutr. 2009;12:122–128. doi: 10.1017/S1368980008002048.
    1. Hoefkens C, Lachat C, Kolsteren P, Van Camp J, Verbeke W. Posting point-of-purchase nutrition information in university canteens does not influence meal choice and nutrient intake. Am J Clin Nutr. 2011;94:562–570. doi: 10.3945/ajcn.111.013417.
    1. Holdsworth M, Haslam C. A review of point-of-choice nutrition labelling schemes in the workplace, public eating places and universities. J Hum Nutr Diet. 1998;11:423–445. doi: 10.1046/j.1365-277X.1998.00124.x.
    1. Lavidge RJ, Steiner GA. A model for predictive measurements of advertising effectiveness. J Mark. 1961;25:59–62. doi: 10.2307/1248516.
    1. Verbeke W. Impact of communication on consumers' food choices. Proc Nutr Soc. 2008;67:281–288. doi: 10.1017/S0029665108007179.
    1. Engel JF, Kollat DT, Blackwell RD. Consumer behavior. Holt, Rinehart & Winston, New York; 1968.
    1. Blackwell RD, Miniard PW, Engel JF. Consumer behavior. South-Western College Pub, Ohio; 2005.
    1. Drichoutis AC, Lazaridis P, Nayga RM. Consumers' use of nutrition labels: a review of research studies and issues. Acad Mark Sci Rev. 2006;9:1–22.
    1. Moorman C, Matulich E. A model of consumers preventive health behaviors - the role of health motivation and health ability. J Consum Res. 1993;20:208–228. doi: 10.1086/209344.
    1. MacKinnon DP, Fairchild AJ, Fritz MS. Mediation analysis. Annu Rev Psychol. 2007;58:593–614. doi: 10.1146/annurev.psych.58.110405.085542.
    1. Kristal AR, Glanz K, Tilley BC, Li SH. Mediating factors in dietary change: Understanding the impact of a worksite nutrition intervention. Health Educ Behav. 2000;27:112–125. doi: 10.1177/109019810002700110.
    1. Lockwood CM, DeFrancesco CA, Elliot DL, Beresford SAA, Toobert DJ. Mediation analyses: Applications in nutrition research and reading the literature. J Am Diet Assoc. 2010;110:753–762. doi: 10.1016/j.jada.2010.02.005.
    1. Belgian Health Council. Voedingsaanbevelingen voor Belgie: Herziene versie [Dietary guidelines for Belgium: Revised version] Belgian Health Council, Brussels; 2009.
    1. Belgian National Food and Health Plan. Mandate project: Food product references to the Belgian National Food and Health Plan (NFHP) nutritional objectives (Final version) Belgian National Food and Health Plan, Brussels; 2007.
    1. Independent Scientific Committee My Choice. Productcriteria Ik Kies Bewust (Versie 3.3) [Nutrition criteria My Choice (Version 3.3)] Independent Scientific Committee My Choice, Brussels; 2008.
    1. Grunert KG, Wills J. A review of European research on consumer response to nutrition information on food labels. J Publ Health. 2007;15:385–399. doi: 10.1007/s10389-007-0101-9.
    1. Almanza BA, Hsieh HMY. Consumer preferences among nutrition labeling formats in a restaurant. J Am Diet Assoc. 1995;95:83–85. doi: 10.1016/S0002-8223(95)00019-4.
    1. Feunekes GI, Gortemaker IA, Willems AA, Lion R, Van den Kommer M. Front-of-pack nutrition labelling: Testing effectiveness of different nutrition labelling formats front-of-pack in four European countries. Appetite. 2008;50:57–70. doi: 10.1016/j.appet.2007.05.009.
    1. Obayashi S, Bianchi LJ, Song WO. Reliability and validity of nutrition knowledge, social-psychological factors, and food label use scales from the 1995 Diet and Health Knowledge Survey. J Nutr Educ Behav. 2003;35:83–92. doi: 10.1016/S1499-4046(06)60044-4.
    1. Fitzgerald N, Damio G, Segura-Perez S, Perez-Escamilla R. Nutrition knowledge, food label use, and food intake patterns among Latinas with and without type 2 diabetes. J Am Diet Assoc. 2008;108:960–967. doi: 10.1016/j.jada.2008.03.016.
    1. Pieniak Z, Verbeke W, Scholderer J. Health-related beliefs and consumer knowledge as determinants of fish consumption. J Hum Nutr Diet. 2010;23:480–488. doi: 10.1111/j.1365-277X.2010.01045.x.
    1. Acharya RN, Patterson PM, Hill EP, Schmitz TG, Bohm E. An evaluation of the "TrEAT Yourself Well" restaurant nutrition campaign. Health Educ Behav. 2006;33:309–324. doi: 10.1177/1090198105284875.
    1. Anderson JC, Gerbing DW. Structural equation modeling in practice - a review and recommended 2-step approach. Psychol Bull. 1988;103:411–423.
    1. Baumgartner H, Homburg C. Applications of structural equation modeling in marketing and consumer research: A review. Int J Res Mark. 1996;13:139–161. doi: 10.1016/0167-8116(95)00038-0.
    1. Bergkvist L, Rossiter JR. The predictive validity of multiple-item versus single-item measures of the same constructs. J Market Res. 2007;44:175–184. doi: 10.1509/jmkr.44.2.175.
    1. Grunert KG, Fernandez Celemin L, Wills J, Storcksdieck genannt Bonsmann S, Nureeva L. Use and understanding of nutrition information on food labels in six European countries. J Publ Health. 2010;18:261–277. doi: 10.1007/s10389-009-0307-0.
    1. Ajzen I. Constructing a TPB questionnaire: conceptual and methodological considerations. .
    1. Jöreskog KG, Sörbom D. LISREL 7: A guide to the program and applications. IL SPSS Inc., Chicago; 1989.
    1. Bollen KA. Structural equations with latent variables. Wiley, New York; 1989.
    1. Hair J, Black W, Babin B, Anderson R, Tatham R. Multivariate data analysis. Pearson Education, Inc., New Jersey; 2006.
    1. Stephenson MT, Holbert RL, Zimmerman RS. On the use of structural equation modeling in health communication research. Health Commun. 2006;20:159–167. doi: 10.1207/s15327027hc2002_7.
    1. Tabachnick BG, Fidell LS. Using Multivariate Statistics. 4. Allyn & Bacon, Massachusetts; 2001.
    1. Browne M, Cudeck R, Bollen K, Long J. Testing structural equation models. Alternative ways of assessing model fit. Sage, Newbury Park: CA; 1993. pp. 136–162.
    1. Bialkova S, van Trijp H. What determines consumer attention to nutrition labels? Food Qual Prefer. 2010;21:1042–1051. doi: 10.1016/j.foodqual.2010.07.001.
    1. Berning JP, Chouinard HH, Manning KC, McCluskey JJ, Sprott DE. Identifying consumer preferences for nutrition information on grocery store shelf labels. Food Policy. 2010;35:429–436. doi: 10.1016/j.foodpol.2010.05.009.
    1. Worsley A. Nutrition knowledge and food consumption: can nutrition knowledge change food behaviour? Asia Pac J Clin Nutr. 2002;11:S579–S585. doi: 10.1046/j.1440-6047.11.supp3.7.x.
    1. Keller SB, Landry M, Olson J, Velliquette AM, Burton S, Andrews JC. The effects of nutrition package claims, nutrition facts panels, and motivation to process nutrition information on consumer product evaluations. J Publ Pol Market. 1997;16:256–269.
    1. Moorman C. The effects of stimulus and consumer characteristics on the utilization of nutrition information. J Consum Res. 1990;17:362–374. doi: 10.1086/208563.
    1. Battistelli P, Cadamuro A, Farneti A, Versari A. Do university students know how they perform? Int Electr J Elem Educ. 2009;2:180–198.
    1. Renner B, Schwarzer R. In: Social psychological foundations of health and illness. Suls J, Wallston KA, editor. Blackwell, Oxford; 2003. Social-cognitive factors in health behavior change.
    1. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38–48. doi: 10.4278/0890-1171-12.1.38.
    1. Park CW, Mothersbaugh DL, Feick L. Consumer Knowledge Assessment. J Consum Res. 1994;21:71–82. doi: 10.1086/209383.
    1. Selnes F, Gronhaug K. Subjective and objective measures of product knowledge contrasted. Adv Consum Res. 1986;13:67–71.
    1. Bandura A. Social foundation of thought and action: a social cognitive theory. Prentice Hall, New Jersey; 1986.
    1. Contento IR, Randell JS, Basch CE. Review and analysis of evaluation measures used in nutrition education intervention research. J Nutr Educ Behav. 2002;34:2–25. doi: 10.1016/S1499-4046(06)60220-0.
    1. Hearty AP, McCarthy SN, Kearney JM, Gibney MJ. Relationship between attitudes towards healthy eating and dietary behaviour, lifestyle and demographic factors in a representative sample of Irish adults. Appetite. 2007;48:1–11. doi: 10.1016/j.appet.2006.03.329.
    1. Petrovici DA, Ritson C. Factors influencing consumer dietary health preventativebehaviours. BMC Publ Health. 2006;6:222. doi: 10.1186/1471-2458-6-222.

Source: PubMed

3
Iratkozz fel