Can human rights standards help protect children and youth from the detrimental impact of alcohol beverage marketing and promotional activities?

Use of environmental scan to assess density, content, and variation of predatory food and beverage marketing in New York City

To explore the presence of predatory food and beverage marketing in different neighborhoods in New York City (NYC), this study describes the methodology of an outdoor environmental scan of the physical environment. The study was conducted in four NYC neighborhoods over a three-week period, in which pairs of trained researchers canvassed designated neighborhoods to document the presence of food and beverage marketing using photographs taken on digital smart phone devices. Commercial areas in the vicinity of NYC Public Schools and NYC Housing Authority campuses located in four neighborhoods with the highest and lowest nutrition related health indicators were studied: South Bronx, Pelham Throggs Neck, Upper West Side, Chelsea/Greenwich Village. Advertisements were coded against 50+ indicators to quantify pertinent variables including the frequency and content of food and beverages advertised and all forms of predatory marketing observed. Comparisons of prevalence and content of food and beverage advertisements and predatory marketing were made across neighborhoods with the highest and lowest health indicators, using chi-squared analysis, and a significance level of p < 0.05. This article demonstrates a disproportionate presence of predatory marketing in low income NYC neighborhoods with negative health outcomes compared to wealthier neighborhoods. Further, this paper demonstrates the benefits and limitations of using an environmental scan methodology to assess predatory food and beverage marketing in a large urban area such as NYC.

Reliability and validity of the Alcohol Marketing Assessment Rating Tool (AMART)

OBJECTIVE

Current national responses to the monitoring and prevention of alcohol marketing to vulnerable populations, such as youth, typically rely on partial bans, co-regulation and industry self-regulation. Efforts to evaluate compliance with existing regulations are often cumbersome and resource intensive. We sought to develop a short questionnaire to assess compliance of alcohol advertising to existing alcohol industry self-regulated marketing codes.

METHODS

Questions for the Alcohol Marketing Assessment Rating Tool (AMART) were taken from a longer rating instrument that was originally developed to detect violations of a self-regulated alcohol marketing code. Secondary analysis of data from three studies of alcohol advertisements was performed to determine the reliability and validity of AMART at detecting code violations, using the longer form as the criterion. One sample was used as an exploratory set. Two samples were used to validate the questionnaire.

RESULTS

In the exploratory set, the reliability of AMART was considered near perfect (kappa = 0.92). Sensitivity was 97%, and specificity was 100%. Positive predictive value (PPV) was perfect and negative predictive value (NPV) was approximately 90%. In the validation sets, reliability was considered substantial to near perfect (kappa = 0.71-0.94). Specificity and PPV remained perfect, and NPV was 86%-90%.

CONCLUSION

The AMART is a reliable tool to detect violations of a self-regulated marketing code in alcohol advertising. It significantly decreases the amount of resources needed to evaluate a finite number of advertisements.