A thematic content analysis of how marketers promote energy drinks on digital platforms to young Australians

Prevalence of energy drink consumption world-wide: A systematic review and meta-analysis

BACKGROUND AND AIMS

The increasing market for energy drinks (EDs) in recent years, as well as the health risks caused by their consumption, prompt calls to estimate the prevalence of ED use among different countries. This systematic review and meta-analysis aimed to synthesize the prevalence of ED use in different continents and age groups.

METHOD

We searched two databases (i.e. PubMed and PsycInfo) on 31 March 2023 to identify studies reporting the prevalence of ED use. A total of 192 studies (196 distinct samples; n = 1 120 613; 53.37% males) from the United States, Europe, Asia, Oceania and Africa were included in the analysis. A random-effects model was applied to estimate the overall pooled prevalence at several time-periods. Subgroup analyses were performed to provide prevalence based on continent and age group. The quality of articles was assessed using Joana Brigg's Institute (JBI) critical appraisal checklist. Measurements included prevalence of ED use (i.e. life-time, past 12 months, past 30 days, past 7 days and daily use), continent and age group (i.e. children, adolescents, young adults and adults).

RESULTS

The life-time ED use world-wide-pooled prevalence was estimated to be 54.7% [95% confidence interval (CI) = 48.8-60.6; I2  = 99.80], 43.4% (95% CI = 36.1-50.6; I2  = 99.92) in the past 12 months, 32.3% (95% CI = 28.8-35.8; I2  = 99.82) in the past 30 days, 21.6% (95% CI = 18.7-24.5; I2  = 99.95) in the past 7 days and 8.82% (95% CI = 6.3-11.4; I2  = 99.95) daily ED use. Subgroups analyses showed significant differences in ED life-time use within age groups (P = 0.002) and continents (P = 0.035).

CONCLUSIONS

The world-wide prevalence of energy drink use appears to be high, particularly among adolescents and young adults.

Health-Washing of Ultraprocessed Products on Instagram: Prevalence and Strategies in an Emerging Market

OBJECTIVE

To evaluate the prevalence of health-related cues as part of the digital marketing of ultraprocessed foods on Instagram among food companies in Uruguay.

METHODS

Cross-sectional exploratory study. All content posted by 118 Instagram accounts of companies promoting ultraprocessed foods in Uruguay over 6 months (from August 2020 to February 2021) was retrieved. The content of 1,893 Instagram posts was coded considering visual and textual cues conveying health-related associations. The number and percentage of posts, including cues within each category and theme, were calculated.

RESULTS

More than half of all posts contained at least 1 visual or textual cue conveying health-related associations. Three main themes emerged: i) product composition, ii) healthy lifestyle, and iii) health and health benefits. The prevalence of health-related cues differed dramatically across product categories, ranging from 100% to 1.5%.

CONCLUSIONS AND IMPLICATIONS

Health-washing constitutes an integral part of the digital marketing of ultraprocessed foods on Instagram in Uruguay. The inclusion of health-related cues can potentially undermine public health efforts targeted at reducing consumption of these foods. These findings suggest that strict and comprehensive regulations on the digital marketing of such products are needed in policies promoting healthy eating habits globally.

A massive hit that targets kids quite a bit: Where and how Australian school children see energy drinks

ISSUES ADDRESSED

Energy drinks (EDs) are not recommended for children due to their high caffeine content and adverse health risks. Their popularity among children may be due to children's exposure to ED marketing. This study aimed to identify where children have seen ED marketing and whether they believe ED marketing targets them.

METHODS

Participant data were drawn from 'AMPED UP: An Energy Drink Study', where 3688 students in grades 7-12 (age 12-17 years) from 25 randomly selected secondary schools in Western Australia were asked if they had ever seen ED advertising on television, posters/signs in shops, online/internet, movies, cars/vehicles, social media, magazines/newspapers, music videos, video games, merchandise and free samples. Participants were also shown three ED advertisements and asked, 'Which age group/s do you think this ad targets?' (12 years or less, 13-17 years, 18-23 years, 24 years or older) and could select multiple age groups for each advertisement.

RESULTS

On average, participants saw ED advertising on 6.5 (SD = 2.5) of 11 possible marketing channels, including television (seen by 91% of participants), posters/signs in shops (88%), online/internet (82%) and movies (71%). Participants also perceived ED advertisements targeted children (< 18 years).

CONCLUSIONS

ED marketing has a high reach among Western Australian children. The voluntary ED advertising pledge to not market EDs to children in Australia does not prevent children from seeing or being targeted by ED marketing. SO WHAT?: Stronger regulatory control of ED marketing is needed to better protect children from the appeal and adverse health risks of ED use.

Evaluating and Tracking Qualitative Content Coder Performance Using Item Response Theory

Content analysis of traditional and social media has a central role in investigating features of media content, measuring media exposure, and calculating calculation of media effects. The reliability of content coding is usually evaluated using "Kappa-like" agreement measures, but these measures produce results that aggregate individual coder decisions, which obscure the performance of individual coders. Using a data set of 105 advertisements for sports and energy drinks media content coded by five coders, we demonstrate that Item Response Theory can track coder performance over time and give coder-specific information on the consistency of decisions over qualitatively coded objects. We conclude that IRT should be added to content analysts' tool kit of useful methodologies to track and measure content coders' performance.

A Scoping Review of Observational Studies on Food and Beverage Advertising on Social Media: A Public Health Perspective

Popular social media platforms have been actively used by ultra-processed food companies to promote their products. Being exposed to this type of advertising increases the consumption of unhealthy foods and the risk of developing obesity and other non-communicable diseases (NCDs). Thus, monitoring commercial content on social media is a core public health practice. We aimed to characterize the methods used for monitoring food advertising on social media and summarize the investigated advertising strategies via a scoping review of observational studies. This study is reported according to the MOOSE Statement, and its protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration nº. CRD42020187740). Out of the 6093 citations retrieved, 26 met our eligibility criteria. The studies were published from 2014 to 2021, mostly after 2018. They focused on Australia, Facebook, strategies aimed at children and adolescents, and advertising practices of ultra-processed food companies. We grouped strategies in eight classes: post features (n = 18); connectivity and engagement (n = 18); economic advantages, gifts, or competitions (n = 14); claims (n = 14); promotional characters (n = 12); brand in evidence (n = 8); corporate social responsibility or philanthropy (n = 7); and COVID-19 (n = 3). We found similarities in the investigation of strategies regardless of the type of social media. Our findings can contribute to the designing of tools for monitoring studies and regulatory mechanisms to restrict the exposure of food advertising.

The content of Instagram posts featuring ultra-processed products through the lens of the heuristic-systematic model

Digital marketing has seen a rapid rise in the last decade as a consequence of the increased popularity of social media. However, few studies so far have analyzed the prevalence and persuasive power of digital marketing of ultra-processed products. The present study aimed at: (i) analyzing the content of Instagram posts of ultra-processed products through the lens of the heuristic-systematic model, and (ii) evaluating the influence of the content of the posts on user interactions. A search for Instagram accounts of ultra-processed products was performed using a master list of products commercialized in the two most popular online supermarkets in Uruguay. For each of the identified Instagram accounts, all the content posted in a 6-month period was recorded (August 15th, 2020 to February 15th, 2021). The posts were analyzed using content analysis based on inductive coding, and gradient boosting models (GBMs) were used to address the second study objective. A total of 2178 Instagram posts promoting specific ultra-processed products or brands were identified. The posts included a diverse set of cues to trigger both systematic and heuristic processing. References to the pleasure derived from product consumption as well as health-related cues were most prevalent. The GBM showed that references to contests and raffles and invitations to interact encouraged users to engage with the posts through posting comments. Taken together, results stress the need to implement comprehensive regulatory approaches to reduce exposure to and the power of digital marketing of ultra-processed products given the harmful health-related consequences associated with excessive consumption of such products.

Experiences with energy drink consumption among Norwegian adolescents

The objective of the present study was to describe adolescents' habits and experiences with energy drink (ED) consumption and the relation to the amount of ED consumed. We used the national cross-sectional study Ungdata, conducted in 2015-16 in Norway. A total of 15 913 adolescents aged 13-19 years answered questions about ED consumption related to the following topics: reasons for, experiences with, habits and parental attitudes. The sample comprised only adolescents reporting to be ED consumers. We estimated the association between the responses and the average daily consumption of ED in multiple regression models. Those who consumed ED 'to concentrate' or 'to perform better in school' consumed on average 73⋅1 (CI 65⋅8, 80⋅3) and 112⋅0 (CI 102⋅7, 121⋅2) ml more daily, respectively, than those who did not consume ED for these reasons. Up to 80 % of the adolescents reported that 'my parents think it is OK that I drink energy drink', but at the same time almost 50 % reported that 'my parents say that I shouldn't drink energy drink'. Apart from increased endurance and feeling stronger, both desired and adverse effects of ED consumption were reported. Our findings indicate that the expectation created by the ED companies have great influence on the adolescents' consumption rate and that parental attitudes towards ED have little to no influence on the adolescents' consumption rate.

Associations between adolescent and young adult External Food Cue Responsiveness (EFCR) and brand recall, product craving and product purchasing in the livestreaming food marketing environment

OBJECTIVE

To evaluate the utility of three validated food responsiveness scales in measuring recall of, and responsiveness to, food marketing exposure on social media.

DESIGN

Cross-sectional survey among adolescents and adults who used the social media platform Twitch.tv (Twitch). Responsiveness to food marketing was self-reported as craving or purchasing any brands participants observed on Twitch. Participants completed three validated scales of food responsiveness: the revised 18-question Three Factor Eating Questionnaire (TFEQ), the external eating subscale of the Dutch Eating Behavior Questionnaire (DEBQ) and the External Food Cue Responsiveness (EFCR) scale. Adjusted linear regression models assessed the predictive ability of each scale on recall and responsiveness outcomes.

SETTING

Online survey.

PARTICIPANTS

Five hundred and sixty-eight Twitch users (90·1 % male, 60·6 % White, 43·7 % aged 18-24, 25·9 % under 18).

RESULTS

In separate adjusted linear regression models, scores on the TFEQ were not related to any outcome, while DEBQ scores related to product cravings (OR: 1·10, 95 % CI 1·01, 1·19, P = 0·02). In contrast, scores on the EFCR scale were significantly associated with higher brand recall (incident rate ratio: 1·42, 95 % CI 1·20, 1·68, P < 0·001), product craving (OR: 3·93, 95 % CI 2·22, 7·17, P < 0·001) and purchasing behaviour (OR: 3·97, 95 % CI 1·99, 8·26, P < 0·001). A subset of three EFCR scale items related to influencer marketing were similarly associated with each outcome with greater precision in the point estimates than the overall EFCR.

CONCLUSIONS

The EFCR scale predicted recall of and responsiveness to food marketing via Twitch, suggesting its utility in monitoring the effects of food marketing on social media.

Global case study of digital marketing on social media by a top soda brand

The Big Soda segment is central in modern food systems, and they invest heavily in digital marketing, but little is known about it. We aimed to analyze the digital marketing on Facebook of the soda brand with a major worldwide reach. Countries were described in terms of soda brand presence and popularity on Facebook according to countries' socio-demographic index (SDI) and the market share of soda brand (%MS). From 149 countries, 57.0% had soda brand's Facebook page among the top five in the number of followers within the beverage segment. Among them, digital marketing was described by the number of the page followers, the number of posts, and the number of interactions (likes, comments and shares) that each post received by Facebook users. Also, we analyzed the characteristics, and the use of marketing strategies on posts in a random sample of 10% (n = 1217) of all posts. We found that soda brand's popularity on Facebook was higher among countries with higher SDI and higher %MS. Also, the number of users that engaged with soda brand's posts was higher among countries with lower SDI and higher brand's %MS. The brand's posts focus on young adults, display of brand's products and glorification of its attributes. Other identified features include sport-related thematic and appeals to socialization and healthy eating. In addition, posts' characteristics differed with countries' characteristics. Soda brand digital marketing varies according to countries' characterization and maintains the brand position on the global marketing of beverages.

'Even if you don't pay attention to it, you know it's there': A qualitative exploration of adolescents' experiences with digital food marketing

Adolescents are particularly vulnerable to digital food marketing. However, research on adolescents' recall, awareness, and opinions of this type of marketing is still scarce. Accordingly, the present study aimed to conduct an in-depth examination of adolescents' experiences with digital food marketing. A convenience sample of 209 adolescents was recruited at two private educational institutions and a public health facility in Montevideo, the capital city of Uruguay. Semi-structured group interviews were conducted, recorded in audio and transcribed. The transcripts were analyzed using content analysis based on a deductive-inductive approach. Results showed that participants were highly exposed to digital food marketing, as they all remembered having seen advertisements, with those of fast-food restaurants and food-ordering apps being the most frequently mentioned. According to the adolescents' accounts, images, colors, music, oversized portions, product novelty, price promotions and celebrities were the most memorable aspects of food advertisements. Participants recognized the effect of advertisements on product awareness and wanting, and, to a lesser extent, on actual purchase and consumption behavior. Factors that were thought to mediate the impact of digital marketing on food choice were also identified. In the final part of the interviews, participants proposed strategies to reduce the effect of digital marketing on their food choices, which included both regulatory approaches to reduce exposure to digital marketing of unhealthy foods and behavior change communication. Together, the current findings provide insights for the development of multifaceted strategies to reduce the effects of digital food marketing on the eating habits of adolescents.

Data on the Facebook marketing strategies used by fast-food chains in four Latin American countries during the COVID-19 lockdowns

OBJECTIVES

During the COVID-19 pandemic, most countries implemented lockdowns that motivated changes in the dietary patterns, physical activity, and body mass index (BMI) of consumers worldwide, as well as the emergence of new food marketing strategies in social media. We sought to design and validate a methodology for monitoring and evaluating the Facebook marketing strategies of multinational fast-food chains in response to the COVID-19 pandemic.

DATA DESCRIPTION

We developed three datasets. First, a dataset with the Uniform Resource Locators (URLs) of 1015 Facebook posts of five fast-food chains present in Argentina, Bolivia, Guatemala, and Peru. Second, a dataset of 106 content-analyzed posts we used in a pilot to determine intercoder reliability using statistical tests. Third, a dataset of a final sample of the 1015 content-analyzed posts that we used to determine the variables most frequently used. Following a mixed-methods approach, we developed 29 variables that recorded general information, as well as the marketing strategies we identified in the posts, including 14 COVID-19 specific variables. These data should help to monitor the social media marketing strategies that fast-food chains have introduced during the COVID-19 lockdowns, thus providing initial evidence about how they could be contributing to an unhealthy food environment.

Use of persuasive strategies in food advertising on television and on social media in Brazil

We analyzed the use of persuasive advertising strategies by 18 food brands on TV and Facebook, Instagram, and YouTube in Brazil in April 2018. Advertising strategies were investigated from three groups: power of advertising strategies (n = 10) (e.g., use of licensed character, celebrities, awards, etc), use of the prize offering (n = 9) (e.g., pay 2 take 3 or more, gifts or collectable, limited edition, etc), and use of brand benefit claims (n = 8) (e.g., messages that exalt sensory-based characteristics such as flavor, taste, aroma and recommend how to use/consume the product, etc). Almost 90% of the brands were ultra-processed foods producers and they carried 52 ads on TV and 194 posts on social media platforms. A higher frequency of the strategy ‘cartoon/company owned character’ was found on TV ads (19.2%; p < 0.0001) in comparison to social media platforms (0% on the three platforms) while the presence of ‘famous sportsperson/team’ prevailed on YouTube (41.4%) in comparison to TV (19.2%), Facebook (10.9%) and Instagram (9.1%), p < 0.0001. On YouTube ads, the claims ‘sensory-based characteristics’ (86.2%), ‘suggested use’ (51.7%), and ‘emotive claims’ (31.0%) were more commonly seen in comparison to the other media, while the claims about ‘new brand developments’ (23.1%), ‘price’ (9.6%) and ‘suggesting to children and the whole family to use the advertised product’ (21.1%) prevailed on TV. Ultra-processed food brands are the main food companies that advertise on Brazilian TV and social media and the message transmitted by these brands varies in each media according to the advertising strategies that are used.

Language and Sentiment Regarding Telemedicine and COVID-19 on Twitter: Longitudinal Infodemiology Study

Background

The COVID-19 pandemic has necessitated a rapid shift in how individuals interact with and receive fundamental services, including health care. Although telemedicine is not a novel technology, previous studies have offered mixed opinions surrounding its utilization. However, there exists a dearth of research on how these opinions have evolved over the course of the current pandemic.

Objective

This study aims to evaluate how the language and sentiment surrounding telemedicine has evolved throughout the COVID-19 pandemic.

Methods

Tweets published between January 1, 2020, and April 24, 2021, containing at least one telemedicine-related and one COVID-19–related search term (“telemedicine-COVID”) were collected from the Twitter full archive search (N=351,718). A comparator sample containing only COVID-19 terms (“general-COVID”) was collected and sampled based on the daily distribution of telemedicine-COVID tweets. In addition to analyses of retweets and favorites, sentiment analysis was performed on both data sets in aggregate and within a subset of tweets receiving the top 100 most and least retweets.

Results

Telemedicine gained prominence during the early stages of the pandemic (ie, March through May 2020) before leveling off and reaching a steady state from June 2020 onward. Telemedicine-COVID tweets had a 21% lower average number of retweets than general-COVID tweets (incidence rate ratio 0.79, 95% CI 0.63-0.99; P=.04), but there was no difference in favorites. A majority of telemedicine-COVID tweets (180,295/351,718, 51.3%) were characterized as “positive,” compared to only 38.5% (135,434/351,401) of general-COVID tweets (P<.001). This trend was also true on a monthly level from March 2020 through April 2021. The most retweeted posts in both telemedicine-COVID and general-COVID data sets were authored by journalists and politicians. Whereas the majority of the most retweeted posts within the telemedicine-COVID data set were positive (55/101, 54.5%), a plurality of the most retweeted posts within the general-COVID data set were negative (44/89, 49.4%; P=.01).

Conclusions

During the COVID-19 pandemic, opinions surrounding telemedicine evolved to become more positive, especially when compared to the larger pool of COVID-19–related tweets. Decision makers should capitalize on these shifting public opinions to invest in telemedicine infrastructure and ensure its accessibility and success in a postpandemic world.

Measuring the Power of Food Marketing to Children: a Review of Recent Literature

PURPOSE OF REVIEW

This scoping review examines literature from the past 5 years (June 2014 to June 2019) across three databases (PubMed, MEDLINE, and Scopus) to detail how the persuasive power of child-targeted food marketing content is addressed and evaluated in current research, to document trends and gaps in research, and to identify opportunities for future focus.

RECENT FINDINGS

Eighty relevant studies were identified, with varied approaches related to examining food marketing techniques to children (i.e., experimental, survey, meta-analyses, mixed methods, content analyses, focus groups). Few studies specifically defined power, and studies differed in terms of techniques examined. Spokes-characters were the predominant marketing technique measured; television was the platform most analyzed; and dominant messages focused on health/nutrition, taste appeals, and appeals to fun/pleasure. Mapping the current landscape when it comes to the power of food marketing to children reveals concrete details about particular platforms, methods, and strategies, as well as opportunities for future research-particularly with respect to definitions and techniques monitored, digital platforms, qualitative research, and tracking changes in targeted marketing techniques over time.