Barriers to Adopting a Plant-Based Diet in High-Income Countries: A Systematic Review

Adopting a plant-based diet (PBD) has been shown to reduce the risk of developing certain diseases and is linked to environmental benefits. This review synthesises the evidence on the barriers adults aged 18 to 65 living in high-income countries (HIC) may experience when adopting a PBD. A systematic literature review was conducted using four search databases: Medline, Embase, Global Health, and Web of Science. Barriers were mapped to behaviour change strategies using the COM-B model. Ten studies were included in the final review, including 1740 participants. Five were qualitative, four were cross-sectional, and one was a pre- and-post-intervention study. In total, 40 barriers were identified and synthesised into 11 themes: financial, lack of knowledge, emotional, health, convenience, social, enjoyment of meat, environmental, accessibility, personal ability, and media. Of the 40 barriers, nutritional intake/requirements (categorised into the "health" theme) had the most evidence. This barrier encompassed concerns around being able to meet nutritional needs if an individual were to adopt a PBD. Habits (in the "personal ability" theme), which included established eating habits and habitual behaviours relating to animal-source foods, had the second most evidence alongside the barrier of not knowing what to eat as part of a PBD (in the "lack of knowledge" theme). Education interventions and communication/marketing policies were the behaviour change mechanisms mapped onto these barriers. Future interventions should focus on informing individuals about what to consume as part of a nutritionally balanced PBD and facilitating habitual dietary change.

Consumers' willingness to buy meat and seafood products close to the expiry date: an exploratory study from Denmark

Introduction

Meat- and seafood products close to their expiry date (MSPCED) are one of the significant contributors to the growing food waste. Therefore, this study aims to investigate consumers' attitudes and willingness to buy MSPCED.

Methods

An online questionnaire was used to collect data from 400 Danish consumers.

Results and discussion

Three consumer segments were identified based on their willingness to buy MSPCED: 39.8% of the participants showed a high willingness to buy MSPCED close to their expiry date ("All High"), 34.5% were selective with a high willingness to buy meat close to their expiry date but not seafood ("High meat, low seafood"), while 25.7% showed a low willingness to buy MSPCED ("All Low"). Consumers' willingness to buy MSPCED is influenced by the perceived quality of the products, food safety, social acceptability, and price. Consumers were willing to pay a higher price for minced beef close to the expiry date when compared to cod fillets, pork cuts, and chicken breasts. However, consumers were willing to buy cod fillets with the lowest discount percentage when compared to pork cuts, minced beef, and chicken breast. The findings suggest that price reduction and discount percentage can have varying effects in influencing willingness to pay for MSPCED. This study provides valuable insights, for food waste practitioners in the retail sector, to develop effective strategies for reducing food waste by influencing consumer willingness to buy and pay for perishable products like meat and seafood.

Right on the money? U.S. dairy farmers' varied understanding of consumer preferences and attitudes towards animal health, welfare and biotechnology

This Research Communication investigates how well U.S. dairy farmers understand the voting behaviour and willingness to pay of consumers for products with production traits relevant to animal health, welfare and biotechnology. Accurately understanding consumer behaviour is key to making sound production decisions and reducing risks. Comparing survey data with the literature shows that U.S. dairy farmers correctly assess consumer attitudes and behaviour over animal welfare practices like pain-controlled dehorning but could improve knowledge of attitudes towards antibiotic use and novel biotechnologies like gene editing.

Consumer Preference for Rice Grain Quality in the South Kivu and Tanganyika Provinces, Eastern DR Congo

In Africa, rice has always been a staple food in some countries and the fastest growing food source there. In the Democratic Republic of Congo (DRC), in terms of cereal production, rice is ranked second after maize and is an important source of income for the rice farmer. The objective of this study was to analyze and understand consumers' preferences and behaviors towards local and imported rice in the South Kivu and Tanganyika provinces, DRC. Data collected on 1565 rice-consuming households in eastern DRC showed that there is a great opportunity for the rice value chain and food policy development, and the promotion of local rice consumption. Consumers focus on local rice because it is cheaper, but it does not always meet their desired needs. Indeed, only urban consumers were more willing to pay for higher-quality rice. The development of the demand for local rice calls for strong investment in improving production, post-harvest practices, and market aspects. It was found that over 90% of rice consumers know about local rice production and over 84% have consumed it. In rural areas, there is typically lower consumption of imported rice. However, as households require more rice, they tend to rely more on imported varieties due to their availability in the market. The most preferred rice attributes were flavor, aroma, purity, swelling capacity, breakage rate, and whiteness. Therefore, rice producers should consider the habits and needs of consumers to improve market demand. In addition, good packaging, labeling, and marketing can also enhance local rice preference and competitiveness in South Kivu and Tanganyika provinces in eastern DRC. The findings of this study indicated that research aimed at improving local rice varieties with regard to yield, disease resistance, and organoleptic qualities could enable the population to consume more locally produced rice, which is often more affordable than imported rice. This could in turn significantly reduce the need for rice imports. These results suggest that research carried out to improve the yield and organoleptic qualities of local rice in this area can allow it to be more competitive on the market and can reduce the importation of rice.

Consumer Preferences and Attitudes towards Antibiotic Use in Food Animals

Antimicrobial resistance (AMR) is one of the major challenges faced by society, with the real threat of the failure of many medical procedures. Antibiotics are also used in livestock production and provide a potential pathway to increasing AMR. The central challenge involves ensuring animal health and welfare while securing the long-term effectiveness of antibiotics. This paper reports the results of a survey of 5693 respondents from the customer panels of four major UK supermarkets regarding preferences and attitudes towards antibiotic use in food animals, and their perspectives on how the balance between animal welfare and human benefit can be achieved. The results of these surveys are consistent with those from other countries that found that consumers generally have limited knowledge about antibiotic use in agriculture and AMR, with around 50% responding "don't know" to many questions. There was agreement about the benefits of antibiotics outweighing harm, with 40% agreeing that, overall, the use of antibiotics to treat disease in farm animals delivers more benefit than harm. However, 44% neither agreed nor disagreed, indicating a high level of uncertainty and a situation that is potentially unstable. The seriousness of the AMR challenge is such that continued action for the more discriminating use of antibiotics must continue.

Australian community pharmacists' experiences during the COVID-19 pandemic

OBJECTIVES

Community pharmacists have played an important role in providing services for their community during the COVID-19 pandemic. In this study, the purpose is to present the attitudes and experiences of Australian pharmacists regarding the COVID-19 pandemic.

METHODS

A qualitative semi-structured interview explored community pharmacist experiences during the initial COVID-19 lockdown. Thematic analysis of transcribed interviews was conducted to investigate the experiences of pharmacists.

KEY FINDINGS

Interviews were conducted with 15 pharmacists from different regional areas and states of Australia. In the study, five main themes were developed: COVID-19 practice complications; pharmacy practice changes; difficult patient interactions; worsened mental well-being and coping strategies; and career dissatisfaction. Pharmacists stated that an increase in workload, shortage of supplies and frequent COVID-19 management updates increased pressure on their duties. The negative customer interactions during COVID-19 lockdown adversely affected some pharmacists' mental health and career satisfaction.

CONCLUSIONS

Community pharmacists are subject to multiple factors affecting their practice, impairing their mental well-being and triggering them to reconsider their career choice. It is important to provide support to community pharmacists to help improve their well-being and workplace satisfaction.

Soy Milk Consumption in the United States of America: An NHANES Data Report

With the increasing adoption of plant-based diets in the United States, more and more individuals replace cow milk with plant-based milk alternatives. Soy milk is a commonly used cow milk substitute, which is characterized by a higher content of polyunsaturated fatty acids and fibers. Despite these favorable characteristics, little is known about the current prevalence of soy milk consumption the United States. We used data from the National Health and Nutrition Examination Surveys (NHANES) to assess soy milk usage in the United States and identified potential predictors for its consumption in the US general population. The proportion of individuals reporting soy milk consumption in the NHANES 2015-2016 cycle was 2%, and 1.54% in the NHANES 2017-2020 cycle. Non-Hispanic Asian and Black ethnicities (as well as other Hispanic and Mexican American ethnicities in the 2017-2020 cycle) significantly increased the odds for soy milk consumption. While a college degree and weekly moderate physical activity were associated with significantly higher odds for consuming soy milk (OR: 2.21 and 2.36, respectively), sex was not an important predictor. In light of the putative health benefits of soy milk and its more favorable environmental impact as compared to cow milk, future investigations should attempt to identify strategies that may help promote its consumption in selected populations.

Effects of Message Framing and Information Source on Consumers' Attitudes toward an Amino Acid-Based Alternative Meat Curing System

Recently, meat scientists have developed an innovative amino acid-based alternative meat curing system (AAACS). However, consumer skepticism toward novel foods presents challenges regarding the acceptance of food innovations like the AAACS. Effective communication about this and other food technologies is critical. Our study was a 2 × 4 randomized factorial between-groups experiment that investigated how two peripheral cues-message frame and information source-impact attitudes toward the AAACS. We used Qualtrics to randomly assign participants to one of eight treatment groups. Each group viewed a different video about the AAACS. Then, all participants were asked about their attitudes toward the alternative meat curing system. Data were analyzed using a two-way multivariate analysis of variance (MANOVA). The two-way MANOVA determined concurrently the experimental effects of message frame and information source on information recall, trust, source expertise, source credibility, and anticipated consumption behavior. A significant MANOVA was followed up using Discriminant Function Analysis (DFA). A significant main effect was found for information source. The DFA revealed only one significant underlying function and that source expertise was the most powerful discriminating variable for information source.

Identifying Differences in Consumer Attitudes towards Local Foods in Organic and National Voluntary Quality Certification Schemes

As no study on attitudes towards local food has compared "organic" and national quality scheme consumer segments, this study aimed to provide further insights and clarifications on the issue of consumer segmentation in terms of trust towards organic food and food of selected quality perceived as local, along socioeconomic characteristics, and other important determinants of this complex interaction. The research examines consumers' attitudes and perceptions related to two quality schemes for special Slovenian foods: "Organic", which relates to production methods; and "Selected Quality", which relates to quality attributes. The study focused on two segments of consumers, who exhibit a high level of trust towards the two quality schemes. Comparative analysis of the consumer segments looked for the potential differences with respect to their sociodemographic profiles, as well as to their understanding of the definition of local food, attitudes towards local food, trust in actors and institutions, and willingness to purchase local food. The study combined qualitative approaches and a quantitative survey with a general population sample. The results showed that both consumer groups have similar understandings of local food, with region-based interpretations outperforming country-based interpretations. The "Organic" group was more cosmopolitan and supportive of the local community, regardless of geographic proximity, than the "Selected Quality" group. Older consumers occupy a larger share of both segments, with professionals and individuals with higher incomes more likely to be in the "Organic" group and retirees and students more likely to be in the "Selected Quality" group. To increase the consumers' interest in food with the "Organic" and "Selected Quality" schemes, more specific product propositions should be developed.

Is Generation Z Ready to Engage in Entomophagy? A Segmentation Analysis Study

This study examines the behavior and attitudes of adult Generation Z cohort members in relation to entomophagy. Specifically, it explores their familiarity with insect consumption, prior experience, and willingness to consume certain insect-based foods and drinks. Lastly, the Z cohort is segmented based on their behavior and attitudes. Through online quantitative research, a valid sample of 742 questionnaires was collected. Data analysis included descriptive statistics, reliability analysis, factor, hierarchical cluster, and K-means cluster analysis, as well as chi-square tests. Results revealed that 41.4% are familiar with what insect consumption is, and no one had previously engaged in entomophagy. The insect-based food that the Z cohort is most willing to try is bakery products containing insect flour. The 88.5% of the Z cohort is not willing to replace meat protein with insect protein, and 20.4% are interested in obtaining more information about entomophagy. Moreover, 6.3% of the Z cohort is "willing" to participate in sensory tests, but when contact information was requested, only one factual name with phone number was provided. Segmentation of the Z cohort's behavior was performed based on eight variables and four segments were identified: the "Future potential insect consumers" (29.1%), the "Rejecters" (26.7%), the "Disgusted, prefer to starve" (22.2%), and the "Inconsistent" (22.0%). Overall, the Z cohort is not food neophobic, but is unwilling to engage in entomophagy. Communication strategies are suggested to increase awareness and provide information about entomophagy and its benefits.

Consumers' Attitudes towards Animal Suffering: A Systematic Review on Awareness, Willingness and Dietary Change

Planetary and human health depend on Westerners' ability to reduce meat consumption. Meat production degrades the environment while excessive meat intake is associated with cancer and cardiovascular disease, among others. Effective reasons and motivations are needed for consumers to change their diet. The fact that modern animal agriculture inflicts a great deal of pain on animals from their birth to their slaughter, animal welfare/suffering may drive consumers to curtail their meat consumption. This systematic review examined a total of 90 papers to ascertain consumers' awareness of the pain animals experience in animal agriculture, as well as consumer attitudes towards meat reduction due to animal welfare. Results show that consumers have low awareness of animal agriculture. Awareness of animal agricultural practices and animal sentience is associated with increased negative attitudes towards animal suffering. Animal suffering due to farming practices, transportation, slaughter, and animal sentience are factors that may encourage a reduction in meat consumption, and even dietary change in the short term. There is also evidence that animal suffering may be a more compelling motivation for consumers' willingness to change their diet than for health or environmental reasons. Therefore, increasing consumers' awareness of animal suffering in meat production is paramount to contributing to reduced pressure on the environment and improved human health.

Going under Dr. Robot's knife: the effects of robot anthropomorphism and mortality salience on attitudes toward autonomous robot surgeons

OBJECTIVE

This study sought to experimentally test two potential factors that could affect the consumer acceptance of autonomous robot surgeons: anthropomorphism and mortality salience. The study also investigated the effect of gender and its interaction with anthropomorphism on attitudes toward autonomous robot surgeons.

DESIGN AND MAIN OUTCOME MEASURES

A between-subjects experiment with a 2 (anthropomorphism: low vs. high) x 2 (mortality salience: no vs. yes) factorial design was conducted (N = 196). The trust in the autonomous surgical robot and the willingness to undergo autonomous robotic surgery served as the dependent variables.

RESULTS

When death thoughts were not active, the human-likeness of the autonomous surgical robot significantly increased the trust in the robot and the willingness to undergo autonomous robotic surgery. Activating death thoughts did not further increase the positive attitudes toward the higher-anthropomorphic robot, while it significantly increased the trust in and the willingness to be operated on by the lower-anthropomorphic robot, rendering both robots comparable. This study also found that women had less positive attitudes toward the autonomous robot surgeon, regardless of the robot's human-likeness.

CONCLUSION

Anthropomorphism and mortality salience can both positively affect the acceptance of autonomous robotic surgery but only in the absence of one another.

Preference-Based Determinants of Consumer Choice on the Polish Organic Food Market

Background: The development of the organic food market in Poland is currently at a fairly high level. There is a growing demand for organic food, but the share of total sales remains low. There are still many barriers related to the availability of organic food and information about it. In addition, consumers are skeptical of the inspection system in organic farming and admit that these foods do not meet their expectations regarding sensory qualities. Methods: The article conducted its own research, using an author's survey questionnaire, which was distributed in Lublin Province. The research sample consisted of 342 respondents and was diverse in terms of gender, age and place of residence. The purpose of the analysis was to ascertain the determinants affecting the choice of organic food. For the study, the method of correspondence analysis was used, the purpose of which was to isolate characteristic groups of consumers who exhibit certain behaviors towards organic products. Results: Respondents admitted that they buy organic food several times a month, most often spending an amount of EUR 10-20 (per month). They also paid attention to product labeling, with labels read mostly by residents of small towns (up to 30,000 residents). Respondents were also asked about the reasons why they do not buy organic food. The results of the analysis show that respondents believe it is too expensive, but they also cannot point out differences with other products. Conclusions: The main purpose of this article was to study the preferences of organic food buyers and to identify factors that determine their choice but that may also be barriers to purchasing this category of food. These issues need to be further explored so as to create recommendations in this regard for various participants in the organic food market.

Consumer Knowledge and Acceptance of "Algae" as a Protein Alternative: A UK-Based Qualitative Study

Overconsumption of meat has been recognised as a key contributing factor to the climate emergency. Algae (including macroalgae and microalgae) are a nutritious and sustainable food source that may be utilised as an alternative to animal-based proteins. However, little is known about the consumer awareness and acceptance of algae as a protein alternative. The aim of this qualitative study was to develop a rich and contextualised understanding of consumer beliefs about the use of algae in novel and innovative food products. A total of 34 participants from the UK assisted with our study. Each participant engaged in one focus group, with six focus groups conducted in total. Existing consumer knowledge of algae was discussed before participants explored the idea of algae-based food products. Reflexive (inductive) thematic analysis was used to analyse these data. Results showed that consumers have limited pre-existing knowledge of algae as a food source; however, participants were open to the idea of trying to consume algae. This anticipated acceptance of algae was influenced by several product attributes, including perceived novelty, edibility, healthiness, sustainability, and affordability. These findings highlight algae as a promising protein alternative to support plant-forward diets in the UK and identify key attributes to consider in future product development and marketing strategies.

Replacing meat with alternative plant-based products (RE-MAP): a randomized controlled trial of a multicomponent behavioral intervention to reduce meat consumption

BACKGROUND

Reducing meat consumption could protect the environment and human health.

OBJECTIVES

We tested the impact of a behavioral intervention to reduce meat consumption.

METHODS

Adult volunteers who regularly consumed meat were recruited from the general public and randomized 1:1 to an intervention or control condition. The intervention comprised free meat substitutes for 4 weeks, information about the benefits of eating less meat, success stories, and recipes. The control group received no intervention or advice on dietary change. The primary outcome was daily meat consumption after 4 weeks, assessed by a 7-day food diary, and repeated after 8 weeks as a secondary outcome. Other secondary and exploratory outcomes included the consumption of meat substitutes, cardiovascular risk factors, psychosocial variables related to meat consumption, and the nutritional composition of the diet. We also estimated the intervention's environmental impact. We evaluated the intervention using generalized linear mixed-effects models.

RESULTS

Between June 2018 and October 2019, 115 participants were randomized. The baseline meat consumption values were 134 g/d in the control group and 130 g/d in the intervention group. Relative to the control condition, the intervention reduced meat consumption at 4 weeks by 63 g/d (95% CI: 44-82; P < 0.0001; n = 114) and at 8 weeks by 39 g/d (95% CI: 16-62; P = 0.0009; n = 113), adjusting for sex and baseline consumption. The intervention significantly increased the consumption of meat substitutes without changing the intakes of other principal food groups. The intervention increased intentions, positive attitudes, perceived control, and subjective norms of eating a low-meat diet and using meat substitutes, and decreased attachment to meat. At 8 weeks, 55% of intervention recipients identified as meat eaters, compared to 89% of participants in the control group.

CONCLUSIONS

A behavioral program involving free meat substitutes can reduce meat intake and change psychosocial constructs consistent with a sustained reduction in meat intake.

Food Traceability as an Element of Sustainable Consumption-Pandemic-Driven Changes in Consumer Attitudes

A conscious approach to the issue of food traceability on the part of consumers is essential for making rational food purchases, which in turn contributes to sustainable consumption and globally, is an element of sustainable development. The study aims to assess the changes in consumers' buying behaviors in the context of food traceability before and during the COVID-19 pandemic, as well as the impact of sociodemographic factors on those changes. Therefore, an online survey was conducted on a sample of 1000 respondents who were Polish food consumers. The study covered aspects related to the traceability of food by consumers before and during the pandemic. The results allowed for positive verification of the H1: Polish consumers attitudes related to food buying process changed during the COVID-19 pandemic. The results didn't allow for fully positive verification of the H2: Sociodemographic factors significantly influence Polish consumers attitudes to the food shopping during COVID-19 period compared to pre-pandemic period. The significant influence was supported in almost all (in 6 out of 8) analyzed aspects in case of age, education, and place of residence. However, in case of gender it was confirmed only in terms of two out of eight aspects: choosing product of national origin and using the online form of ordering purchases.

Functional Food-Consumer Motivations and Expectations

This review provides insight into consumer attitudes toward functional food (FF), with the purpose of better understanding the needs and behavior regarding this kind of product. A total of 47 articles were selected for this paper. The available studies from last 20 years differ according to the focus (awareness, attitudes, motivations, willingness, acceptance by consumers) and methodologies used. Several factors, including socio-demographic, cognitive and attitudinal ones, seem to be serve as the basis for the acceptance of functional products. The research papers showed that nutritional knowledge is the most important of these. Older people are more interested in functional products than younger consumers, because of their stronger belief in the health benefits of FF. Moreover, women are more open to compromise between taste and health properties. Claims concerning the disease preventative properties of FF are the most attractive for consumers. This review focuses also on future perspectives for the functional food market. Adequate knowledge and evidence-based communication seem to be the most promising ways to increase consumers’ interest in these kinds of products.

Asian carp: A threat to American lakes, a feast on Chinese tables

Asian carp, which are widely distributed in Asia and Europe, are nutritious and popular with consumers. In China, Asian carp is a tasty dish and has been consumed for thousands of years. However, they are considered aggressive invasive species that threaten rivers, lakes, and indigenous species in the United States. Asian carp have proliferated greatly in the water basin of the Mississippi River and its tributaries, and they have caused severe ecological problems over the past 20 years. In recent years, several state governments along the Mississippi River have implemented assistance programs to eliminate invasive Asian carp, but these did not alleviate the threat. We conducted a survey to understand consumers' attitudes toward Asian carp in the United States, and related reports were reviewed to explore the possibility of Asian carp as food fish on American tables. Emphasis is placed on the farming history, functional characteristics, consumption preferences, and successful utilization methods for Asian carp in China. In addition, suggestions and possible utilization methods were proposed to improve the negative impression of Asian carp in the United States. Further research is needed to take full advantage of this huge excellent source of food or health supplements. This review provides ideas and directions for the use of Asian carp in the United States. We believe that through effective cooperation between China and the United States, the negative aspects of Asian carp in the United States could be diminished, and a mutually beneficial situation could be achieved.

Consumers' Perspectives on Eggs from Insect-Fed Hens: A UK Focus Group Study

In recent years, there has been growing interest in insects as an alternative to soybean meal as laying hen feed due to nutrition, sustainability, and animal welfare benefits. Although some studies have investigated consumer acceptance and intentions towards insect-fed foodstuffs, no studies are available on eggs from insect-fed hens. This qualitative study aimed to explore consumers’ attitudes and perceptions towards eggs from insect-fed hens and factors influencing intentions to consume and purchase the product. Three focus group discussions were employed with a total of 19 individuals from the UK. Results showed that the environmental, animal welfare, and food waste benefits of feeding hens with insects positively influenced attitudes. Results also indicated price and disgust towards insects as feed were the main barriers, while enhanced welfare standards (e.g., free-range labelling) and information on benefits were main drivers. Therefore, the study suggests that educating and informing consumers about the benefits of feeding hens with insects may increase intentions to consume and purchase eggs from insect-fed hens. Given this emerging area of research, this study contributes to the limited literature on insect-fed foodstuffs and paves the way for further research on the topic.

Market Opportunities for Hay Milk: Factors Influencing Perceptions among Italian Consumers

Central and South Italy are characterized by small-scale dairy farms and growing abandonment by farmers for other, better-paid, off-farm jobs. New marketing concepts for milk can be one solution to remunerate mountain farmers for their efforts. This study investigates the potential market for hay milk in Italy. In particular, we want to understand which variables drive the people's willingness to consume hay milk, and if the European food quality certification schemes impact on people's willingness to consume milk from hay-fed cows. Data were collected from a sample of consumers from Central and South Italy (n = 331) using a web-based survey. Later, a discrete choice probit model was applied. The main results indicate that aspects as curiosity, the production place of food, the local culinary traditions, label, and environmental issues play an important role in the people's consumption intentions for milk from hay-fed cows. Moreover, the survey highlights that the respondents had positive opinion towards hay milk and highlighted some important marketing implications for the Italian milk sector. The study findings could encourage discussion about a niche market to boost local growth, initiating a process of improving livelihoods, certification of products, and use of the marketing tools addressed towards a specific milk consumer's profile. In other words, the study could provide useful implications for food manufacturers and facilitate the design of marketing strategies for hay milk produced in Central and South Italy.

Sensory and Conceptual Aspects of Ingredients of Sustainable Sources-Finnish Consumers' Opinion

Sustainable strategies that enable development of alternative sustainable novel ingredients for food are needed to ensure adequate resources for food in the future. Determining consumer attitudes and acceptance of novel ingredients is essential for wider usage of products including these ingredients. The purpose of the study was to reveal consumers' perspectives on novel, and partly traditional but marginally utilized, ingredients to be used in regular cooking and their sensory characteristics and nutritional and environmental aspects. Consumer attitudes were obtained with two online consumer surveys. Consumer surveys revealed the most interesting ingredients. Plant-based ingredients are preferred over raw materials of animal or insect origin and these are also perceived as more pleasant. Plants were also regarded as credible, ecological, natural, healthy and nutrient-rich. Finnish consumers are not ready to adopt insects into their diet. Neither synthetic meat nor three-dimensional printed food have potential without further knowledge or experience of consumers. Findings of this research give baseline information on consumer attitudes towards novel ingredients. Further research is needed to investigate the perceived pleasantness when the potential ingredients are tasted.

Motivations and Barriers for Sheep and Goat Meat Consumption in Europe: A Means-End Chain Study

This international study involving seven European countries (Italy, UK, Finland, France, Spain, Greece, Turkey) was conducted to explore the relevant reasons that affect both consumer and non-consumer perceptions of sheep and goat meat. Laddering and means-end chain theory were applied. The results indicate that consumers associate sheep and goat meat with a unique taste, authenticity and natural production, linked with values such as health and enjoyment of life. In contrast, non-consumers mainly feel disgusted when they think and feel about these meats, and do not associate any specific health benefits to their consumption, disliking their taste, odour and fat content. This study is based on qualitative research. Only analytical generalizations are possible, expanding the theory on what drives consumer behaviour when purchasing meat. No previous means-end chain studies are available in the literature regarding small ruminants' meat consumer preferences.

Consumer Awareness, Attitudes and Preferences Towards Heritage Cereals

Interest in heritage cereals is increasing among consumers, bakeries and farmers, and the trends point towards the local production of crops and connect to sustainability. The most known variety is spelt, which has opened up for old landraces such as Oland wheat. Heritage cereals have shown a higher resilience than modern varieties and have the potential to supply the market with alternative products that have an attractive cultural background. Delicious and nutritious products based on heritages cereals have a growing market potential. Consumers' attitudes and preferences to different products are affected by factors such as age, gender and education. The aim of this study was to investigate and analyse different consumer groups' awareness, attitudes and preferences toward heritage cereals. The number of respondents who participated in this study and answered the web-based questionnaire was 434. It can be concluded that most consumers are aware of heritage cereals. Geographic background had an influence, while academic background did not. Bread and pasta are the most consumed products and are regarded as the most popular future products to be based on heritage cereals. The most essential factors in bread are taste and flavour, followed by freshness and texture. The origin of the cereal and its health aspects are important; women are more concerned about the origin than men, while older consumers are more concerned about health. Older consumers are also more willing to pay extra for heritage cereal than younger consumers.

Applying the Behavioural Change Wheel to Encourage Higher Welfare Food Choices

Simple Summary

Public concern for animal welfare in food production continues to grow. However, its growth does not correspond with the increase in demand for higher welfare products, giving rise to an outcome known as the attitude–behaviour gap. Addressing this attitude–behaviour gap and supporting consumers to make higher animal welfare choices in the supermarket can play important roles in improving the lives of farm animals. Despite increasing awareness in this area, solutions aimed at minimizing this gap often focus on knowledge transfer and have not yet had a significant impact. The aim of this article is to review current knowledge around the attitude-behaviour gap, and situate it within the context of the behaviour change wheel; exploring the capabilities, opportunities, and motivations driving, as well as the barriers preventing consumers from making higher welfare food choices. Using this framework, the review aims to broadly identify how consumers can be encouraged to change their behaviour and buy higher welfare products.

Abstract

Over the last several decades, positive public attitudes towards animal welfare have continued to develop. Consumers’ attitudes towards farm animal welfare indicate increasing concern about animal welfare in food production. Yet, this growing interest in the lives of farm animals does not correspond with a wholesale increase in demand for higher welfare products, providing evidence of the citizen-consumer attitude-behaviour gap (herein referred to as the attitude-behaviour gap). Minimising the attitude–behaviour gap and supporting consumers to make higher animal welfare choices may help producers to enhance the lives of farm animals. However, despite increasing awareness in this area, solutions to resolve this gap often focus on knowledge transfer and do not appear to have had a significant impact. The aim of this article is to review current knowledge around the attitude-behaviour gap, and situate it within the context of the behaviour change wheel; exploring the capabilities, opportunities, and motivations driving, as well as the barriers inhibiting consumers from making higher welfare food choices. Using this framework, the review aims to identify interventions that may boost consumer demand for higher welfare products sold at a premium price and provide suggestions for future research. Further work to increase understanding in this area is then also suggested.

Harmful Compounds and Willingness to Buy for Reduced-Additives Salami. An Outlook on Italian Consumers

The consumption pattern of salami has been subjected to relatively widespread attention by academician, but few studies concerning the health implications of salami consumption have been published. Since additives and product origins represent important attributes for salami, the objective of this paper is twofold: (i) to explore the role of two additives, salt and nitrates, in addition to the Italian origin, in relation to consumer attitudes and preferences towards salami, (ii) to segment consumer behaviour by assessing their willingness-to-buy salami, in order to verify whether different purchasing patterns can be identified within the different social groups. The analysis was conducted on two different levels. The first was developed through a conjoint analysis, while the second implemented a frequency analysis based on a bivariate analysis. Results show the price as one of the most important variables in identifying the quality level of salami, in addition, certain socio-economic segments of consumers show a significant propensity to pay an additional price for salami with a low salt content and is nitrate-free.

Consumer Attitudes Towards Environmental Concerns of Meat Consumption: A Systematic Review

Meat consumption is a major contributor to global warming. Given the worldwide growing demand of meat, and the severe impact of meat production on the planet, reducing animal protein consumption is a matter of food security and public health. Changing consumer food behavior is a challenge. Taste preferences, culinary traditions and social norms factor into food choices. Since behavioral change cannot occur without the subject’s positive attitude based on reasons and motivations, a total of 34 papers on consumer attitudes and behavior towards meat consumption in relation to environmental concerns were examined. The results show that consumers aware of the meat impact on the planet, willing to stop or significantly reduce meat consumption for environmental reasons, and who have already changed their meat intake for ecological concerns are a small minority. However, environmental motives are already appealing significant proportions of Westerners to adopt certain meat curtailment strategies. Those who limit meat intake for environmental reasons are typically female, young, simply meat-reducer (not vegan/vegetarian), ecology-oriented, and would more likely live in Europe and Asia than in the U.S.

Awareness and Attitudes Regarding Industrial Food Fortification in Mongolia and Harbin

This study assessed awareness and attitudes regarding industrial food fortification among adults in urban and rural Mongolia, and the city of Harbin, China. Between 2014 and 2017, surveys were collected from healthy men and women aged ≥18 years (182 Harbin residents and 129 urban and rural Mongolians participating in a nationwide nutrition survey in Mongolia). Survey reproducibility was assessed among 69 Mongolian participants to whom it was administered twice (summer and winter). Findings revealed that only 19% of rural and 30% of urban Mongolians, and 48% of Harbin residents were aware that industrial fortification is practiced in their countries. For most food groups evaluated, at least half of Mongolians and less than half of Harbin residents thought fortification was government-mandated (only the addition of iodine with salt is actually mandated in both countries). Fifty-five percent of rural and urban Mongolians favored mandatory fortification of foods, 14% disapproved of it, and 31% were uncertain (compared with 25%, 38%, and 37% respectively in Harbin). Upon learning that the primary purpose of adding vitamin D to milk is to prevent rickets, 75% of Mongolians but only 18% of Harbin residents favored mandatory fortification, while 42% of Harbin residents favored voluntary fortification (compared with <10% of Mongolians). In conclusion, in Mongolia and Harbin, awareness and understanding of food fortification is low, as is receptivity toward mandatory fortification. Health promotion and social marketing should be designed to create an enabling environment for increasing supply and demand of fortified foods, in support of upcoming program implementation in Mongolia and potential future legislation in northeern China.

The Science of Salt: A focused review on salt-related knowledge, attitudes and behaviors, and gender differences

The aim of the current review was to examine the scope of studies published in the Science of Salt Weekly that contained a measure of self-reported knowledge, attitudes, and behavior (KAB) concerning salt. Specific objectives were to examine how KAB measures are used to evaluate salt reduction intervention studies, the questionnaires used, and whether any gender differences exist in self-reported KAB. Studies were reviewed from the commencement of Science of Salt Weekly, June 2013 to the end of August 2017. Seventy-five studies had relevant measures of KAB and were included in this review, 13 of these were salt-reduction intervention-evaluation studies, with the remainder (62) being descriptive KAB studies. The KAB questionnaires used were specific to the populations studied, without evidence of a best practice measure. 40% of studies used KAB alone as the primary outcome measure; the remaining studies used more quantitative measures of salt intake such as 24-hour urine. Only half of the descriptive studies showed KAB outcomes disaggregated by gender, and of those, 73% showed women had more favorable KAB related to salt. None of the salt intervention-evaluation studies showed disaggregated KAB data. Therefore, it is likely important that evaluation studies disaggregate, and are appropriately powered to disaggregate all outcomes by gender to address potential disparities.

What role could community pharmacists in Malaysia play in diabetes self-management education and support? The views of individuals with type 2 diabetes

OBJECTIVES

This study explored the experiences and views of individuals with type 2 diabetes mellitus (T2D) on their diabetes self-management and potential roles for community pharmacists in diabetes self-management education and support (DSME/S) in Malaysia.

METHODS

A qualitative study, using semi-structured, face-to-face interviews, was conducted with patients with T2D attending a primary care health clinic in Kuala Lumpur, Malaysia. The interviews were audio-recorded, transcribed verbatim and analysed inductively.

KEY FINDINGS

Fourteen participants with T2D were interviewed. Data were coded into five main themes: experience and perception of diabetes self-management, constraints of the current healthcare system, perception of the community pharmacist and community pharmacies, perceived roles for community pharmacists in diabetes care, and challenges in utilising community pharmacies to provide DSME/S. There were misconceptions about diabetes management that may be attributed to a lack of knowledge. Although participants described potential roles for community pharmacists in education, medication review and continuity of care, these roles were mostly non-clinically oriented. Participants were not confident about community pharmacists making recommendations and changes to the prescribed treatment regimens. While participants recognised the advantages of convenience of a community pharmacy-based diabetes care service, they raised concerns over the retail nature and the community pharmacy environment for providing such services.

CONCLUSION

This study highlighted the need to improve the care provision for people with T2D. Participants with T2D identified potential, but limited roles for community pharmacists in diabetes care. Participants expressed concerns that need to be addressed if effective diabetes care is to be provided from community pharmacies in Malaysia.

Factors predicting meat and meat products consumption among middle-aged and elderly people: evidence from a consumer survey in Switzerland

Background: An adequate diet contributes to health and wellbeing in older age. This is nowadays more important than ever since in industrialised countries the elderly population is growing continually. However, information regarding the consumption behaviour of older persons in Switzerland is limited. Objective: The objective of this investigation was to explore how middle-aged and elderly Swiss view animal products in relation to diet and health, and what factors predict consumption frequency. Design: A representative consumer survey among 632 people over the age of 50 years, living in the German-, French- and Italian-speaking regions of Switzerland was conducted. Results: This paper presents the results related to meat and meat products consumption. Most participants consumed meat and meat products regularly. The majority of participants with low meat intake indicated that eating small amounts would be enough. Respondents judged fresh meat (except pork) to be healthier than meat products, and poultry to be the healthiest meat. Overall meat consumption frequency was predicted by language region, gender, household size, and BMI. Furthermore, participants' opinion about healthiness, taste and safety of meat but not their adherence to the Swiss food pyramid was found to be correlated to the consumption frequency of individual types of meat. Conclusion: Several factors have an impact on consumption frequency of meat and meat products in the middle-aged and elderly Swiss population and the importance varies according to the individual types of meat and meat products. The results show that the traditional food pyramid is not one of these factors for which reason new tools must be explored to support elderly people in regard to a healthy dietary behaviour.

Consumer attitudes towards evidence based mental health services among American mental health consumers

The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes.

Knowledge and beliefs of young people about medicines in the UK

OBJECTIVES

To investigate knowledge and beliefs regarding medicines among young people in the South-East of England.

METHODS

A cross-sectional survey was conducted among young people aged 12-17 years in three state secondary schools which participated in the Pharmacy and Biomedical Sciences Outreach Program (POP) - scientific workshops in south-east England.

KEY FINDINGS

One hundred questionnaires were successfully completed giving a response rate of 75%. The median knowledge score was 62.3% (±19.8). Increase in knowledge of medicines was positively associated with increase in age and with a positive belief about medicines. One of the questions answered that scored less than 50% was concerning the use of antibiotics.

CONCLUSIONS

Knowledge of medicines appeared to be adequate among young people and was higher with a positive belief about medicines. However, there was variability in how well different questions were answered suggesting inclusion in the school curriculum would be beneficial in order to reduce the misinformation that was apparent, particularly regarding the potential non-adherence to antibiotics.

Evaluating pharmacist prescribing for minor ailments

OBJECTIVES

Saskatchewan is the second Canadian province to allow pharmacists to prescribe medications for minor ailments and the only province that remunerates for this activity. The aim of this project was to determine whether patients prescribed such treatment by a pharmacist symptomatically improve within a set time frame.

METHODS

Pharmacists were asked to hand a study-invitation card to anyone for whom they prescribed a medication for a minor ailment during the 1-year study period. Consenting participants contacted the study researchers directly and were subsequently instructed to complete an online questionnaire at the appropriate follow-up time.

KEY FINDINGS

Ninety pharmacies in Saskatchewan participated, accruing 125 participants. Cold sores were the most common minor ailment (34.4%), followed by insect bites (20%) and seasonal allergies (19.2%). Trust in pharmacists and convenience were the most common reasons for choosing a pharmacist over a physician, and 27.2% would have chosen a physician or emergency department if the minor ailment service were not available. The condition significantly/completely improved in 80.8%; only 4% experienced bothersome side effects. Satisfaction with the pharmacist and service was strong; only 5.6% felt a physician would have been more thorough.

CONCLUSIONS

Participants were very satisfied with their symptomatic improvement and with the service in general, albeit for a small number of conditions. Participants reported getting better, and side effects were not a concern. These results are encouraging for pharmacists; however, a comparison of physician care with pharmacist care and unsupported self-care is required to truly know the benefit of pharmacist prescribing.

Consumer demand as a driver of improved working conditions: the 'Ergo-Brand' proposition

This article develops and explores the 'Ergo-Brand' proposition, which posits that consumers may prefer to buy goods that are made under good working conditions (GWCs). This preference would enhance a differentiation strategy for companies, thereby fostering the application of ergonomics in production. This proposition is developed in the context of a narrative review of the literature on 'ethical consumerism'. This is supplemented with a survey study, conducted in both Canada and Sweden (n = 141) to explore this proposition. Results indicate that consumers would prefer goods made under GWCs, but not unconditionally as quality and price concerns were ranked higher. Access to information on the working conditions in production was seen as a barrier. Nevertheless, the Ergo-Brand concept may be a viable avenue in promoting attention towards ergonomics in companies - particularly if consumer habits are subject to intervention by advertising. Further research on this strategy is warranted.

Perceptions of disease aetiology and the effect of own behaviour on health among poly-pharmacy patients with non-Western backgrounds in Denmark

OBJECTIVES

To examine the perceptions of disease aetiology and the effect of own behaviour on health among poly-pharmacy patients with non-Western backgrounds in Denmark.

METHODS

The study was based on 26 extended medication reviews with patients of non-Western backgrounds aged 50+ who use at least four prescription drugs regularly. The reviews were conducted by 12 pharmacists with the same mother-tongue background as the participants. The reviews included patient interviews on which the data in this article are based. In total, four open-ended questions from the patient interviews were analysed by the means of Giorgi's phenomenological method.

KEY FINDINGS

The analysis shows that stress was most commonly perceived as the cause of the participants' diseases for reasons that included (1) having left their country of origin and family, (2) worry over the political situation in their country of origin and (3) the problems involved in living as an immigrant in Denmark. Most of the participants perceived their own efforts as having little impact on their own health status, although some participants considered them as having considerable influence.

CONCLUSIONS

To a great extent, the explanations of the participants about possible disease aetiology are focused on stress, immigration and psychological well-being. Although many participants perceived that their own efforts did not have much impact on their health status, our study revealed a large diversity in the responses of non-Western immigrants, particularly regarding the importance of their own efforts on their health status.

Developing an integrated treatment for substance use and depression using cognitive-behavioral therapy

Providing a unified treatment approach to meet the substance abuse and mental health needs of clients is the preferred model for addressing co-occurring disorders. We developed a group-based cognitive-behavioral (CBT) integrated treatment for depression and substance use disorders (SUD) that could be delivered by counselors in SUD treatment settings and evaluated its feasibility and acceptability. We conducted an in-depth case study examining one implementation of the treatment using 15 focus groups with clients (n = 7) and semistructured interviews with counselors (n = 2) and administrators (n = 3). Using CBT as a treatment approach to integrate the treatment was widely accepted by clients, counselors, and administrators. Clients stated the treatment was applicable to multiple aspects of their lives and allowed them to recognize their clinical improvements over time. Counselors and administrators discussed challenges for long-term feasibility. Key decisions used to develop the treatment and recommendations for implementing integrated care in SUD settings are discussed.

Consumer Attitudes and Market Response to Irradiated Food

Results of consumer attitude and markets studies worldwide indicate consumers will accept irradiated food. Major studies in the United States indicate the number of consumers concerned about the safety of irradiated food has decreased in the last 10 years and continues to be less than the number of those concerned about pesticide residues, microbiological contamination, and other food-related concerns. The number of people reporting no concerns about irradiated food is among the lowest for food issues, comparable to that of people with no concern about food additives and preservatives. Numerous studies have demonstrated that acceptance increases when consumers are provided with information about specific advantages of the irradiation process. Consumers view irradiated meat and poultry products positively, with half or more interested in purchase. Concern about irradiation centers around safety, nutritional quality, potential harm to employees, and potential danger from living near an irradiation facility. Women, people with lower incomes, and those with less formal education are more likely to express concern. Marketing of irradiated food in the United States, although limited, has been successful. Irradiated foods marketed in numerous countries were judged superior by consumers and sold well. These studies indicate that the market potential for irradiated food is strong. Consumers should receive information about irradiation advantages and environmental and worker safeguards.

Consumer Attitudes Toward Irradiated Food: Results of a New Study

A survey was conducted to determine current consumer attitudes toward irradiation. The mailed questionnaire was designed to be self-administered. Results were obtained from responses of 54% of 918 questionnaires mailed out to consumers in the metro-Atlanta area. Results indicated that 72% of consumers are aware of irradiation and, among these, 87.5% indicated that they have heard about irradiation but do not really know that much about it. Over 30% of consumers believe that irradiated food is radioactive. Consumers are less concerned about irradiation than they are about food additives, pesticide residues, animal drug residues, growth hormones, and bacteria. The risk to workers and environmental issues are among the top concerns regarding irradiation. The percentage of consumers who would buy irradiated food is 45%; 19% would not buy it, and others are undecided. Results indicate that a more favorable response will be observed when a choice of irradiated poultry, meats, and seafood is offered.