#communicatehealth

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[communicatehealth]

'Seductive names' make vegetables more appealing - BBC News

Twisted citrus-glazed carrots and sweet sizzlin' green beans anyone?

An interesting read! 

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Using the 'ripple effect' to achieve health goals

After a car crash five years ago, Laura Banks sank into a sedentary rut.

Starting small can lead to big changes!

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Amsterdam’s solution to the obesity crisis: no fruit juice and enough sleep.

Boseley, S. (2017, April 14). Amsterdam's solution to the obesity crisis: no fruit juice and enough sleep. The Guardian. Retrieved April 21, 2017 from https://www.theguardian.com/society/2017/apr/14/amsterdam-solution-obesity-crisis-no-fruit-juice-enough-sleep.

The purpose of this news story is to inform the public about the steps that Amsterdam (Netherlands) is taking to help reduce childhood obesity in the city, as one-fifth of children there are overweight (which has dropped by 12% between 2012 and 2015).

Amsterdam’s campaign does not just focus on schools or families, but communities as a whole. In schools, students are only allowed milk or water (no juice or squash [concentrated syrup] due to the amount of sugar) and the schools keep different vegetables on hand for students to try. The program also encourages students to get enough sleep. Near one school, De Achtsprong, which has a high population of Suriname migrants, they’ve even partnered with the McDonald’s next door to prevent students from buying fries without a parent, only allowing them to purchase an apple if they are alone.

The article states that, in the beginning, parents did not agree with taking away the sugary drinks and treats, but that it has now become normal to eat healthier at schools. In addition, healthy cooking classes are offered to parents and children across the city, teaching them how to cook healthier versions of traditional dishes. Even sporting events have been affected by the changes in Amsterdam – companies such as Burger King and Monster Energy cannot co-sponsor sporting events, and other proposed changes include banning soda advertisements and selling healthy food at the events. Gym (sport center) memberships are also subsidized for low-income families to encourage them to get active. Counselling for mothers-to-be and health education focusing on the first three years of a child’s life is another step Amsterdam is taking to help alleviate the childhood obesity epidemic.

I think this is important because if Amsterdam can take the steps necessary to improve the lives of its citizens, then cities in the United States should take action as well. However, due to the extreme amount of individualism in the U.S., I do not know if such action will be possible without citizens screaming that not allowing their children to drink Pepsi at school infringes upon their rights and does not affect anyone else (even though declining health of the population does affect every citizen).

With the prevalence of preventable diet-based diseases, I think that it is imperative that these community-based changes start to take hold, especially here in the United States. An unhealthy population leads to an unhealthy country.

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The Food We See, The Food They Eat: The Image of Food in Entertainment.

Rosenthal, E. L. (2015, August). The Food We See, The Food They Eat: The Image of Food in Entertainment. Retrieved from the Hollywood, Health & Society website: https://hollywoodhealthandsociety.org/sites/default/files/attachments/page/The%20Food%20We%20See%20Report.pdf

The purpose of this paper was to examine the results of content analysis done on television show data relating to food and food consumption collected between January and May of each year (excluding 2007 and 2008) from 2004 to 2013 via the TV Monitoring Project. The questions this paper was able to answer via the content analysis were which diseases were depicted most on television, how health messages were framed to achieve positive effects, if certain people were exposed to more health-related messages than others and which issues were most prominent in the plot or as part of a larger character arc.

Fifty different types of food (under the umbrella of either “healthy food” such as fruits and vegetables [three food codes: (1) fruits, (2) vegetables or (3) fruit/vegetable {“unable to tell” pp. 4} or “unhealthy food” such as desserts and other sweets [seven food codes: (1) cakes, cookies, etc., (2) donuts, (3) ice cream, (4) candy, (5) chocolate, (6) other desserts or sweets, or (7) desserts and sweets {“unable to tell” pp. 4}]) were coded so they could be measured in each episode (N= 1334), with another measure for food shown and another for food consumed. If either healthy or unhealthy food was shown or consumed, it was marked with a yes or no, resulting in four categories ([1] fruits and vegetables shown, yes or no, [2] fruits and vegetables consumed, yes or no, [3] dessert and sweets shown, yes or no, [4] desserts and sweets consumed, yes or no).

The results show that nearly 80% (79.1%) of shows show some type of food, though it did not have to be either fruits/vegetables or desserts/sweets. Both healthy and unhealthy food were shown in about 30% of the episodes, with desserts/sweets being more likely to be consumed at 14.6% as compared to fruits and vegetables (9.3%). Despite the similar instance of appearance for fruits and vegetables and dessert/sweets, those watching still see the desserts and sweets being consumed more often, which may affect their own eating habits.

This research is important because if we, as a society, can encourage producers and directors to increase the amount of fruits and vegetables (and other healthy food) shown being consumed, then maybe more Americans will be encouraged to engage in similar behavior. Another tactic could be showing characters actively choosing a healthier alternative, such as a scene showing a character putting down a candy bar or energy drink, and instead choosing grapes or a black coffee or tea.

Further research could look into developing specific television shows with optimal exposure to healthy habits to encourage the public to cultivate better habits. These television shows or movies would have to address a variety of audiences from a variety of cultural, socio-economic and other demographic backgrounds. PBS could be of use here, as it is available for free and operates in different areas; different regions could show different programming to better reach the target audiences.

For example, Crawford County, Kansas is one of the poorest counties in Kansas. A television show focused on bettering health in the region could focus on the struggles of being working-class in a relatively rural community and having to find the time to cook healthy food in a town that’s culture is dominated by (friendly) rivaling fried chicken restaurants.

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Entertainment Education Saves Lives and Improves Health: Key Steps to Developing Effective Programs.

Jacoby, C., Brown, J., Kumar, U. B. & Velu, S. (2014). Entertainment Education Saves Lives and Improves Health: Key Steps to Developing Effective Programs. In D. K. Kim, A. Singhal & G. L. Kreps (Eds.) Health Communication: Strategies for Developing Global Health Programs, vol. 5 (pp. 83-100). New York: Peter Lang.

In this book chapter, the authors discuss entertainment education and its effectiveness in increasing knowledge (and change) in regards to different public health issues. The overall goal of entertainment education is to shift societal norms and behaviors as well as to create a positive attitude in regards to implementing the changes necessary.

The article has short case studies, detailing different entertainment education campaigns and their effects. It also includes the basic steps of creating an entertainment education production, which is detailed below.

1.     Audience assessment, theory and technical brief.

In this step, the needs, beliefs and demographics of the target audience are analyzed to get an accurate picture of who the target audience is. From that, the producers must decide, based on the information gathered, which behavior-change theory (social cognitive theory [SCT – learning from the behavior of others; people will replicate what they see as having positive consequences; goal of strengthening self-efficacy] or extended parallel process model [EPPM – change will happen if people perceive that there will be great negative consequences if they do not and having others model the correct behavior; people must believe that they have the ability to change {a high self-efficacy}]) will be most effective to create change within the target audience.

The technical brief includes the above information, as well as the behavior objectives (what changes they want to see and how to measure them), communication objectives (what they want to the audience to understand or walk away with), a call to action (what individuals can do), creative concerns (style, visuals, editing, etc), along with other considerations, such as location and other needs.

2.     Artistry and pretesting

The next step is to make sure that the story and characters proposed in 1 will be relatable to its target audience and that the target audience will want to emulate the good habits of those in the story. As the chapter states, characters must be relatable, unique, believable, have quirks/flaws that help drive the plot and they must be human when implementing the changes to improve their life (by failing and trying again, making mistakes, etc). The story itself must touch the target audience with a conflict that goes beyond just health. Pretesting is important because it shows how well a sample audience will like a story; focus groups can be one way for producers to study this.

3.     Implementation

Implementation begins with promoting the film or series to garner interest in it. Without interest, no one will watch it and thus no one will learn from it. Community engagement is part of this step, the authors say. Community engagement can include group discussions, infographics, handouts, and social media.

4.     Evaluation

After the show or film premieres, researchers can study the effects of the production on the audiences’ behavior, from those were both directly and indirectly exposed to it.

The authors offer some suggestions for those thinking about making a film or movie in entertainment education style, which boils down to something relatively simple: cooperate and form partnerships. Form partnerships with distributers, partner with companies in the private sector, cooperate with community leaders or governmental resources (such as the CDC, in the case of the United States), cooperate with experts in the communication and health fields and hire the best people for the job.

The purpose of this chapter is to inform readers on the steps necessary to create an effective health campaign in the guise of entertainment; this is important to me because, as more Americans become overweight and obese, there needs to be an effective way to get a public health message to them that they will not immediately write off. In short, if they see a beloved character taking steps to improve their health and fitness, and to decrease (or alleviate) weight-related disease, they may be inspired or gain the belief that they, too, can take control of their consumption habits.

[communicatehealth]

Increased food energy supply is more than sufficient to explain the US epidemic of obesity

Swinburn, B., Sacks, G., & Ravussin, E. (2009). Increased food energy supply is more than sufficient to explain the US epidemic of obesity. The American Journal of Clinical Nutrition, 90(6), 1453-1456. doi: 10.3945/​ajcn.2009.28595

The purpose of this study was to determine whether or not an increase in energy intake (via food and beverages) or decrease in physical activity levels contributed to the levels of obesity seen in the United States, and which one is the “major driver” of the obesity increase in order to better target prevention measures (p. 1453).

The authors used doubly-labeled water to test the total energy expenditure (TEE) of children and adults (n= 963 and n= 1,399, respectively) in the 2000s (p. 1453). Because a majority of people are relatively weight-stable for each single day, energy intake (TEI) and TEE were assumed to be equal, due to fact that human bodies “are constrained by the first law of thermodynamics,” which means that “equations can be used to predict changes in weight in response to changes in energy intake and physical activity,” (p. 1453). The data gathered in the 2000s (1999 to 2002) were compared to data from the 1970s (1971 to 1976), which was from the National Health and Nutrition Examination Surveys (NHANES) that measured the heights and weights of both adults and children in the United States (p. 1453). The food supply level was also measured to estimate the per-capita energy supply, which would be over the amount of food actually consumed due to food spoilage and waste (p. 1453).

The energy supply was then apportioned between children and adults based on the ratio of children to adults, which was then used in the equation for estimated weight increase (and then compared to measured weight gains for the age ranges) (p. 1454).

The results showed that the estimated food energy intake for children from ages 2 through 18 was 1,690 kcal per day (at 35.1 kg in weight) in the 1970s and 2,043 kcal per day (at 39.1 kg in weight [identical to predicted weight gain based on the equation]) in the 2000s (p. 1454). Adults consumed on average 2,398 kcal per day (at 68 kg in weight) in the 1970s, which increased to 2,895 kcal per day (at 76.6 kg in weight [slightly lower than the 78.8 kg predicted weight]) in the 2000s (p. 1454). Due to the adult weight being slightly lower than expected, the authors suggest that physical activity may have increased from the 1970s to the 2000s (p. 1454).

The major findings of this article show that increased food consumption is sufficient to explain the increase in obesity across the United States (p. 1454) which is supported by other studies showing the same as well as studies showing that physical activity has not decreased nor increased significantly since the 1970s (p. 1455). However, the authors state that in countries where there is less car ownership, the rise in obesity has a less-steep trajectory, suggesting that reductions in physical activity do not appear to be the driving force behind the rise in it (p. 1455).

The authors state that:

For the US population to return to the mean weights of the 1970s, the increased energy intake of ~1500 kJ/d (350 kcal/d) for children (about one can of soda and a small order of French fries) and 2000 kJ/d (500 kcal/d) for adults (about one large hamburger) would need to be reversed. Alternatively, compensatory increases in physical activity (~150 and 110 min/d of extra walking respectively) would achieve similar results (p. 1455).

This research is important because it shows that weight loss does not just happen in the gym or on the treadmill or sweating and being miserable, as some would see it, but that it can be accomplished through diet and lifestyle changes (via decreasing calorie intake). To improve this research I would have participants keep detailed food and exercise diaries, or have participants placed on a diet that was overlooked by medical professionals, in order to show to everyone that yes, too many calories do cause weight gain and having a higher expenditure than intake will cause weight loss.

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Evolution of Well-Being and Happiness After Increases in Consumption of Fruit and Vegetable.

Mujcic, R. & Oswald, A. (2016, August). Evolution of Well-Being and Happiness After Increases in Consumption of Fruit and Vegetable. American Journal of Public Health, (106)8, 1504-1510. DOI: 10.2105/AJPH.2016.303260.

This article exams whether peoples’ well-being and happiness increases after they increase their intake of fruits and vegetables with the goal of bettering the unhealthy diet Westerners’ have (p. 1504). If the public is informed of the short-term effects of increasing fruit and vegetable consumption, they may be more likely to do so, which could lead to a healthier lifestyle overall (p. 1504).

The authors used a longitudinal study, with food diaries from 12,389 Australians aged 15 to 93 from the years 2007 and 2009 (with a validity check from the years 2009 and 2013) via an in-person national survey given to roughly 14,000 Australians (p. 1504-1505). Participants were asked how many times per week they ate either fruit and how many times per week they ate vegetables (0 [never] to 7 days per week) as well as how many servings (guesstimated by being visually shown a serving size) they ate on the days they ate fruits or vegetables (p. 1505). The average Australian ate 3.84 servings (combined) each day, (SD= 2.01) with some eating zero servings per week (a none consumption category) (p. 1505). Total, roughly 85% of respondents ate less than 3 servings of fruit while 60% ate less than 3 servings of vegetables; very few, 1.83% and 7.75%, age more than 5 servings of fruit and vegetables each day, respectively (p. 1505). Demographics such as “household income, age, education, whether working, marital status, health, children, alcohol and food patterns, BMI, and exercise” were controlled for (p. 1506).

To measure well-being and happiness, participants were asked to (1) rate on a scale from 0 to 10 how satisfied they were, overall, with their life (with an average of 7.91, SD= 1.41); and (2) to indicate how much time in the past month they had “been a happy person” with answers ranging from none of the time (1%; coded at 1), a little of the time (4.8%), some of the time (13.9%), “a good bit of the time” (19.5%), most of the time (51.9%) and all of the time (8.9%; coded at 6) – the participants averaged 4.43 out of 6 for the happiness scale (p. 1505).

The results showed that those who ate more fruits and vegetables were substantially happier (a statistically significant result) (p. 1506). The authors also checked their results against differing lengths/intensities of public health campaigns in the various states of Australia, as different states had differing health campaign time frames (p. 1508). Do to that, the authors found that, “some evidence that the Australian healthy-eating campaign may have improved people’s levels of life satisfaction and happiness, [but] [n]evertheless, it is not possible statistically to be certain of that conclusion,” (p. 1509).

One of the implications of this research, as the authors touch on, is that, “implications of fruit and vegetable consumption are estimated to be substantial and to operate within the space of 2 years— too quickly to be a reflection of the physical advantages of diet for outcomes such as cardiovascular disease,” (p. 1509) which means that public health campaigns could focus on the fast effects of changing one’s diet, instead of the longer-term effects, which may seem too far away to be real for some people.