Hodgkins Charo, Raats Monique, Fife-Schaw Christopher, Peacock Matthew, Groeppel-Klein A, Koenigstorfer J, Wasowicz G, Stysko-Kunkowska M, Gulcan Y, Kustepeli Y, Gibbs M, Shepherd Richard, Grunert KG (2015)Guiding healthier food choice: systematic comparison of four front-of-pack labelling systems and their effect on judgements of product healthiness, In: British Journal of Nutrition113(10)pp. 1652-1663
Cambridge University Press
Different front-of-pack (FOP) labelling systems have been developed in Europe by industry and organisations concerned with health promotion. A study (n 2068) was performed to establish the extent to which inclusion of the most prevalent FOP systems--guideline daily amounts (GDA), traffic lights (TL), GDA+TL hybrid (HYB) and health logos (HL)--impact consumer perceptions of healthiness over and above the provision of a FOP basic label (BL) containing numerical nutritional information alone. The design included within- and between-subjects factors. The within-subjects factors were: food (pizzas, yogurts and biscuits), healthiness of the food (high health, medium health and low health) and the repeated measurements under BL and test FOP label conditions. The between-subjects factors were: the system (GDA, TL, GDA+TL hybrid, HL), portion size (typical portion size and a 50% reduction of a typical portion) and country (the UK, Germany, Poland and Turkey). Although the FOP systems tested did result in small improvements for objective understanding under some conditions, there was little difference between the provision of an FOP label containing basic numerical nutritional information alone or between the various systems. Thus, any structured and legible presentation of key nutrient and energy information on the FOP label is sufficient to enable consumers to detect a healthier alternative within a food category when provided with foods that have distinctly different levels of healthiness. Future research should focus on developing greater understanding of the psychological and contextual factors that impact motivation and the opportunity to use the various FOP systems in real-world shopping settings.
Hodgkins Charo, Egan Bernadette, Peacock Matthew, Klepacz Naomi, Miklavec Krista, Pravst Igor, Pohar Jure, Gracia Azucena, Groeppel-Klein Andrea, Rayner Mike, Raats Monique (2019)Understanding How Consumers Categorise Health Related Claims on Foods: A Consumer-Derived Typology of Health-Related Claims, In: Nutrients11(3)
The Nutrition and Health Claims Regulation (NHCR) EC No 1924/2006 aims to provide an appropriate level of consumer protection whilst supporting future innovation and fair competition within the EU food industry. However, consumers’ interpretation of health claims is less well understood. There is a lack of evidence on the extent to which consumers are able to understand claims defined by this regulatory framework. Utilising the Multiple Sort Procedure (MSP), a study was performed (N = 100 participants across five countries: Germany, the Netherlands, Slovenia, Spain and the United Kingdom) to facilitate development of a framework of health-related claims encompassing dimensions derived from consumers. Our results provide useful insight into how consumers make sense of these claims and how claims may be optimised to enhance appropriate consumer understanding. They suggest consumers may not consciously differentiate between a nutrition claim and a health claim in the way that regulatory experts do and provide insight into where this might occur. A consumer-derived typology of health-related claims based on three key dimensions is proposed: (1) Familiarity with the nutrient, substance or food stated in the claim; (2) statement type in terms of simplicity/complexity; (3) relevance of the claim, either personally or for a stated population group.
There has been little previous scholarship regarding the aims, options and impact of ethics education on residential care-givers. This manuscript details findings from a pragmatic cluster trial evaluating the impact of three different approaches to ethics education. The focus of the article is on one of the interventions, an immersive simulation experience. The simulation experience required residential care-givers to assume the profile of elderly care-recipients for a 24-hr period. The care-givers were student nurses. The project was reviewed favourably by a university ethics committee, and participants provided informed consent. Data from six postsimulation experience focus groups were analysed thematically and three themes were identified: the experience of vulnerability, dignity in care and the organisation of care. Findings suggest that the immersive simulation experience had a powerful immediate impact as participants described epiphanous insights relating to their care experiences. It is suggested that reflecting on and recording epiphanous events has the potential to sustain ethical care practices. Further research is required to evaluate the impact of different ethics education interventions in different cultural contexts. Exploration is also required regarding the meaning and significance of care epiphanies, those “most delicate and evanescent of moments,” for the sustainability of ethical care.
Purpose: To review the literature focusing on the effects of dietary behavioural changes on cancer patients’ health-related quality of life (HRQOL). Methods: Relevant databases were searched for studies that report the relationship between dietary changes and HRQOL of people with cancer and synthesized and systematically reviewed the available evidence. Papers were assessed for methodological quality and the themes identified were summarized. Results: The selected studies included only randomized-controlled trials, which target changes in diet. Twelve studies were identified which focus on the association between lifestyle changes which included changes in diet and HRQOL among cancer patients. Results have been mixed and dietary changes have been shown to partly affect HRQOL, but other factors seem to be important as well in defining that relationship. Moreover cancer groups with higher survival rates (prostate, breast, colorectal) seem to benefit more from dietary changes while different HRQOL constructs are affected with no clear indication of directional benefits on physical or mental health. Conclusions: Even though there are some indications of a direct relationship between dietary changes and HRQOL further research should establish which areas of HRQOL are directly affected. Perhaps nutritional changes in future interventions can be isolated in order to identify a potential direct relationship with HRQOL.
Timotijevic Lada, Banks Carys, Rusconi Patrice, Egan Bernadette, Peacock Matthew, Seiss Ellen, Touray Morro, Gage Heather, Pellicano C., Spalletta G., Assogna F., Giglio M., Marcante A., Gentile G., Cikajilo I., Gatsios D., Konitsiotis S., Fotiadis D. Designing a mHealth Clinical Decision Support System for Parkinson’s Disease: A Theoretically Grounded User Needs Approach, In: BMC Medical Informatics and Decision Making20(34)
BMC (Springer Nature)
Background: Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson’s Disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty. Methods: A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson’s Disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N=47). Study 2 carried out computational modelling of prescribing clinicians’ (N=12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians’ (N=18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both. Results: Study 1 indicated that system development should move away from the traditional silos of ‘motor’ and ‘non-motor’ symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients’ overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient’s condition from the patient’s self-report and the wearable devices. 3 Conclusions: Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment.
The rise in use of food supplements based on botanical ingredients (herbal supplements) is depicted as part of a trend empowering consumers to manage their day-to-day health needs, which presupposes access to clear and accurate information to make effective choices. Evidence regarding herbal supplement efficacy is extremely variable so recent regulations eliminating unsubstantiated claims about potential effects leave producers able to provide very little information about their products. Medical practitioners are rarely educated about herbal supplements and most users learn about them via word-of-mouth, allowing dangerous misconceptions to thrive, chief among them the assumption that natural products are inherently safe. Print media is prolific among the information channels still able to freely discuss herbal supplements.
This study thematically analyses how 76 newspaper/magazine articles from the UK, Romania and Italy portray the potential risks and benefits of herbal supplements.
Most articles referenced both risks and benefits and were factually accurate but often lacked context and impartiality. More telling was how the risks and benefits were framed in service of a chosen narrative, the paucity of authoritative information allowing journalists leeway to recontextualise herbal supplements in ways that serviced the goals and values of their specific publications and readerships.
Providing sufficient information to empower consumers should not be the responsibility of print media, instead an accessible source of objective information is required.
This paper discusses findings from an immersive simulation pilot project whereby six domiciliary care-givers took on the profile of people receiving domiciliary care. Five domiciliary care-givers received care in their own homes and one received care in the training area of their domiciliary care company. Care was delivered by 2nd and 3rd year student nurses with support from a registered nurse. The following themes from post-intervention interviews and a focus group with the care-givers who assumed the profile of a care-recipient (simulants) are discussed: Recognising the need for stimulation; Reflecting on the importance of person-centred communication; The value of companionship and confidence in care-givers; Understanding boundaries and vulnerabilities; and Empathy and practice changes.
After the experience most participants reported viewing care differently and being more attuned to the wishes of care-recipients.
Objective: Health claims on food packaging are regulated to inform and protect consumers, however many consumers do not accurately interpret the meaning of the claims. Whilst research has shown different types of misinterpretation, it is not clear how those interpretations are formed. The aim of this study is to elicit the causal beliefs and causal models about food and health held by consumers, i.e. their understanding of the causal relationships between nutrients, health outcomes and the causal pathways connecting them, and investigate how well this knowledge explains the variation in inferences they draw about health benefits from health claims.
Method: 400 participants from Germany, the Netherlands, Spain, Slovenia, and the UK were presented with 7 authorised health claims and drew inferences about the health benefits of consuming nutrients specified in the claim. Then their personal causal models of health were elicited along with their belief in the truth and familiarity with the claims.
Results: The strength of inferences about health benefits that participants drew from the claims were predicted independently by the strength of the relevant causal pathways within the causal model, and belief in the truth of the claim, but not familiarity with the claim. Participants drew inferences about overall health benefits of the nutrients by extrapolating from their causal models of health.
Conclusion: Consumers’ interpretation of claims is associated with their belief in the claim and their causal models of health. This prior knowledge is used to interpret the claim and draw inferences about overall health benefits that go beyond the information in the claim. Therefore efforts to improve consumers’ understanding and interpretation of health claims must address both their wider causal models of health and their knowledge of specific claims.