A Public Health Messaging Campaign to Reduce Caloric Intake: Feedback From Expert Stakeholders

Weight Stigma in Online News Images: A Visual Content Analysis of Stigma Communication in the Depictions of Individuals with Obesity in U.S. and U.K. News

Weight stigma is a pervasive form of discrimination worldwide. News media, and news images in particular, can reinforce weight stigma by portraying persons with obesity in a negative, stereotypical manner. Informed by the model of stigma communication, this study conducted a content analysis of images accompanying obesity-related news articles from the U.S. and U.K. to determine and compare the prevalence of stigmatizing images. Images (N = 445) in obesity-focused news articles obtained from the top four most viewed online news in the U.S. (n = 244) and U.K. (n = 201) during August 2018-August 2019 were systematically coded. These 445 images featured 228 individuals. Of these 228 individuals, 35% were identified as higher weight and 44% as lower weight. Overall, 70% of persons of higher weight in these news images were depicted in a stigmatizing manner. Further, 46% of individuals with higher weight were depicted with their head partially or fully removed from the image, compared to 25% of individuals with lower weight. Additionally, U.K. news were 2.5 times more likely to contain stigmatizing images than U.S. news. These findings highlight the prevalence of weight stigma in news images and suggest that broader systemic efforts are needed by the news media industry to eliminate the use of negative imagery that marginalizes persons of higher weight.

Healthy Choices Catch On: Data-informed Evolution of a Social Marketing Campaign

OBJECTIVE

Describe how a multiyear, mixed-methods evaluation informed the evolution of a healthy eating and physical activity social marketing campaign.

DESIGN

Focus groups, A/B survey to test messages and images, telephone interviews (2019) with local programmers, and an annual outcome survey.

SETTING

Statewide through multiple channels: billboards, transit signs, social media, website, and program resources like banners and posters.

PARTICIPANTS

Supplemental Nutrition Assistance Program-Education eligible adults, focusing on mothers and caregivers.

INTERVENTION(S)

Healthy Choices Catch On originally launched in 2006 and has since evolved.

MAIN OUTCOME MEASURE(S)

Fruit and vegetable consumption, physical activity, and campaign recall.

ANALYSIS

Univariate descriptive statistics and multivariate, weighted linear regression modeling. Interview transcriptions were analyzed for common themes.

RESULTS

The multiyear evaluation demonstrated a steady increase in campaign exposure from 2013 to 2017, followed by a decline when new messages and images were introduced in 2018 and 2020. People with greater exposure to messages were more likely to eat more fruits and vegetables and be physically active.

CONCLUSIONS AND IMPLICATIONS

Using a combination of evaluation methods can help inform campaign design and evolution while also demonstrating reach and impact.

Physical Activity and Quality of Life in Adult Men and Women with Distorted Perception of Weight Status: Nationwide Surveys (KNHANES 2016-2018)

This study analyzed the distorted perception of weight in adults aged 20 years or older and investigated the difference in the amount of physical activity and health-related quality of life (HRQOL). This study examined 21,326 adults regarding their body mass index (BMI), subjective body recognition (SBR), physical activity (according to the Global Physical Activity Questionnaire; GPAQ), and HRQOL (EuroQol-5 Dimension; EQ-5D) from the 7th Korea National Health and Nutrition Examination Survey (2016−2018). Independent t-test, analysis of variance (ANOVA), chi-square test, and multiple regression analysis were conducted. The group with the same BMI and SBR significantly showed a long time of activity vigorous-intensity (F = 21.25, p = 0.003) and moderate-intensity time (F = 17.24, p < 0.001). In the ‘BMI = SBR’ group, the sub-group with normal BMI and normal SBR showed the highest vigorous-intensity (mean ± SD = 7.20 ± 26.05, F = 37.86, p < 0.001) and moderate-intensity (mean ± SD = 13.89 ± 30.18, F = 43.27, p < 0.001) activity times. The sub-group with normal BMI and normal SBR had the highest percentage of responding as normal in the five EQ-5D sub-items. For the score of the EQ-5D Index, the highest score was shown in the group that felt subjectively more obese than the actual BMI (F = 56.83, p < 0.001). In the ‘BMI = SBR’ group, these factors related to physical activity (vigorous-intensity, moderated-intensity, and walking) are factors influencing health-related quality of life in this regression model (F = 396.57, p < 0.001, R2 = 0.165). Various health promotion programs and policy recommendations to reduce the distorted perception of weight are required.

Formative evaluation of a portion control and calorie reduction campaign: Insights from focus groups with target audience

Healthy eating campaigns can increase awareness of healthful foods and eating patterns and prompt behavior change. Portion control can be a useful strategy in weight management efforts, and new, innovative campaigns can help invigorate messages related to portion control and weight management. This qualitative study presents results of formative testing of portion control and calorie reduction messages and infographics for a proposed campaign. We conducted 17 focus groups with 113 adults ages 18-65 years in 3 US cities. We conducted separate focus groups by weight status (overweight/healthy weight) and gender (male/female) and analyzed coded data and categorized emerging themes. Participants, especially those with healthy weights, gravitated toward specific, and achievable messages to encourage portion control and calorie reduction. Men with overweight and women with healthy weights preferred messages that had a positive, supportive tone. Participants favored messages that addressed overeating and allowed for autonomy. In particular, women and those with healthy weights preferred messages that encouraged calorie budgeting. Many participants, in particular men, provided positive feedback on messages encouraging a "fresh start" on Mondays. Additionally, participants preferred messages that were colorful, informative, realistic, attractive, and relatable. With regard to message dissemination, participants suggested that messages and infographics be positioned in high-traffic areas and men generally suggested places where food decisions are made. Moreover, participants suggested message dissemination through trusted health professionals and credible research organizations. Health organizations planning a portion control or calorie reduction campaign should consider these factors early in the development process to help ensure acceptance and success.