WHAT WOULD YOU CHOOSE? WILL TRAFFIC LIGHT LABELS INFLUENCE YOUR LUNCH BREAK CHOICE?

BY THERESA KONESKI

INTRODUCTION:

Workplace canteens have always been subjected to criticisms, whether they don’t offer enough choices, the choices are considered unhealthy, patrons are dissatisfied with the prices, and whether there are convenient options available (Nordström, 2012).

This is a growing concern from both sides of the food service system because canteens are a business which needs to please the consumers, but they still need to remain profitable (Pridgeon & Whitehead, 2012).

Poor nutrition habits can directly affect obesity and cholesterol, but it can also increase risks of chronic diseases, like heart disease, stroke, type II diabetes, high blood pressure, osteoporosis and certain cancers. Changing dietary behavior will lower the risks of these conditions but can be difficult to prove to the employer in order to gain a supportive work environment which aims to improve employee health (Cavill and Rutter, 2014).

There is also an increasing trend towards improving the workplace environment to support employee health (Story, Kaphingst, Robinson-O’Brien & Glanz, 2008).

INTRODUCTION:

Story, Kaphingst, Robinson-O’Brien, and Glanz (2008) state how workplaces are now taking an active role in supporting their staff in developing healthy behaviors and offering better food options.

More people are eating outside of the home on a daily basis, this food tends to be higher in calories, fat, sugars, salt as well as low in fiber, fruit, and vegetables (Cavill et al., 2014).

There is a growing need to improve the food environment in which the food is being purchased, if the dining out environment can be changed to support healthier purchases than there may be a trend of supplying healthier items in the home as well (Cavill et al., 2014).

In trying to assess the outcomes when employees are asked to choose what they intend to eat strictly based off of a menu, eliminating environmental and olfactory influences, to see if they end up consuming what they originally intended once they have seen the food.

Furthermore, if the menu and food options have nutrition information supplemented with traffic light labeling for easy processing, it would be interesting to evaluate how many individuals would change their mind on what they would like to eat.

LITERATURE REVIEW:

Unhealthy dietary behaviors can be contributed to numerous factors, including taste preferences, convenience of unhealthy foods, lack of nutritional knowledge or misperceptions, and habit. Therefore, changing the environment in which the public chooses their food can improve their dietary behaviors. In order to accomplish this on a larger scale, simple and easy for all to understand, color-coded nutrition labeling can effectively aid the consumer in their food selection (Thorndike, Riis, Sonnenberg & Levy, 2014).

Quintiliani, Poulsen, and Sorensen (2010) describe how healthy choices can be influenced by adapting the environment in which the consumer is encouraged to eat more fruits and vegetables, eat less fat, sugar and salt.

Furthermore, Quintiliani et al. (2010) explains by adding more healthy options to choose from, including labels to cue healthy choices, providing health education and lowering healthy food prices, consumers will be prompted to pick the healthier options.

LITERATURE REVIEW:

Sparling (2010) describes how worksites are an optimal setting to support healthy diet and behavior because of the ability to have long-term co-worker support networks, influence on food availability in canteens, worksite factors and a stable environment.

In providing a workplace based intervention, Campbell et al. (2008) found that improving consumer education and self-efficacy were major components in predicting if the desired behavior would be executed.

Lemon et al. (2010) used strategies like providing hand-outs, increasing healthy food availability, and providing nutrition labels.

Cialdin and Reno (1991) state that an individual’s behavior is largely influenced by social norms and how they perceive the behavior that their peers are performing.

Various studies have shown that there are numerous physiological and psychological process which happens whenever individuals are around food and/or drink (Spence, 2011).

LITERATURE REVIEW:

The obesity epidemic and associated diseases, like coronary heart disease, high blood pressure, and type II diabetes, are a healthcare concern across the globe. A main contributor to obesity is the increased availability of calorie-dense food options. Nutrition labeling has been shown to influence positive food choices and help the public avoid harmful nutrients. Thus food companies will be forced to provide healthier foods in order to meet the demands for better options and therefore remain profitable(Helfter 2014).

Workplace canteens have the ability to affect employees’ long-term health because of the amount of time employees spend at work. Many canteens provide quick, convenient food options, and until recently are usually unhealthy. The workplace canteen is now being encouraged to support a healthy diet and behavior because they can influence the food availability at work and provide a stable environment which can offer long-term support (Sparling 2010).

The goal of this intervention is to gain an understanding of whether providing nutrition information as well as stop light labeling will effectively influence healthier food choices at workplace canteens.

OBJECTIVES:

Objective 1: Upon completion of the practicum, I will assess 12-15 patron’s menu cards regarding what they intended to eat, using their indication on the menu instrument, versus what they actually ate, using their consumer choice survey, once they selected their food at the Training Restaurant Suite.

Objective 2: Upon completion of the practicum, I will assess 12-15 patron’s menu cards regarding what they intended to eat when given the corresponding nutrition information as well as stop light labeling, versus what they actually ate, using their consumer choice survey, once they selected their food at the Training Restaurant Suite. 

Objective 3: Upon completion of the practicum, I will analyze 12-15 patron’s reasoning behind their food selection, using a consumer choice survey, from before and after they were provided with the nutrition information and stop light labeling at the Training Restaurant Suite.

Objective 4: Upon completion of the practicum, I will compare 12-15 patron’s food selection, using what they indicated on the menu cards, from before they were provided with nutrition information to after, at the Training Restaurant Suite.

THEORETICAL PERSPECTIVE:

Developing an intervention, theory based education programs are proven to be more effective (Ajzen, 1991).

The theory of Planned Behavior is the guiding framework for this practicum (Ajzen, 1991) which is designed to investigate the following constructs:

Perceived behavioral control: is an individuals self-efficacy to perform the behavior. This construct is addressed by providing the traffic light labeling with the nutrition information to

enhance the clarity of which menu option would be a good choice. The basic menu selection and the menu selection with nutrition labeling will be compared to evaluate

whether the perceived behavioral control has been demonstrated. Attitude: is the individuals beliefs of whether the behavior of choosing healthier lunch time

meals, is favorable and if choosing these meals will lead to better health outcomes, which the individual must value in order to perform the behavior. The consumer choice survey is used to evaluate whether this behavior is important to them by asking

questions regarding why they chose these food items for lunch and will be evident in their actual meal selection.

THEORETICAL PERSPECTIVE: Subjective norm: is whether a salient other approves of the behavior, and if

so, will influence the individual to perform the behavior. This construct is not focused on for this intervention because this target audience is not

easily influenced by social pressures. A question on the consumer choice survey asked whether a significant person supports

this behavior to see if that is a reason for picking healthier foods. Behavioral intention: is the perception that the individual believes they will

or will not perform the behavior ahead of time. Since the behavioral intention is the most important determinant of whether the behavior is performed, it is therefore the most salient construct for this intervention (Ajzen, 1991). This construct is evaluated by comparing whether the participants followed their food

choice intentions and whether the nutritional information influenced them to choose a healthier option.

MODIFIED FROM AJZEN’S (1991) THEORY OF PLANNED BEHAVIOR:

METHODS:

Study site: The intervention was conducted at the Training Restaurant Suite in Dorset House at Bournemouth University. This facility is the workplace canteen for the faculty of the university.

Recruitment: The participants are regular patrons of this canteen, dining here at least 2-3 times per week in order to participate. The participants were recruited at the canteen.  

Study Design: The participants will be issued menu cards to fill out before they see the food that is offered and thus asked to indicate what they intend to eat. The participants will also be issued a consumer choice survey to fill out once they have eaten to record what they decided to eat and why they chose those foods.

Questionnaire: The survey used for the baseline and intervention assessment was developed and modified from validated research done by Steptoe, Pollard, and Wardle (1995) as well as Sonnenberg, Gelsomin, Levy, Riis, Barraclough, and Thorndike (2013).

Data analysis: Once data was collected the declared reasons behind food selections were categorized into related themes to assess whether their were trends. The data was coded and was analyzed to assess the averages of the participants claims.

BASELINE ASSESSMENT:

 Consisted of assessing the participants’ intentions regarding what they anticipated to eat versus what they actually ate.

Participants were asked to indicate on their menu cards what they intended to eat before they saw the food options.

After selecting their food choices they indicated what they actually ate and the reasons why they chose those food items.

The mean reasons behind food selection were compared to the mean reasons behind food selection when given nutrition information.

The data was analyzed in regards to whether their original intentions were a healthier option and if they switched to a less healthy option or vice versa.

This evaluation provided the baseline to see how the participants chose their food and if they acted on their intentions. Thus providing data to compare with the intervention assessment to see if providing nutrition information and traffic light signaling will affect their food choice decisions.

BASELINE OUTCOMES:

53% of participants actually selected the food items that they had intended to eat.

From the group of participants that selected different food than what they had intended, 37.5% of those participants picked a less healthy food option.

From the group of participants that selected different food than what they had intended, 37.5% of those participants picked a healthier option.

From the group of participants that selected different food than what they had intended, 25% of those participants picked a different option which was neither better nor worse in healthfulness.

BASELINE OUTCOMES:

The following is based on the reasoning’s behind participants’ food choice. The reasoning’s are based on a scale of importance; ranging from not at all important to a little important, then moderately important and finally very important. Many of these reasons have not seen any or much change when provided with the nutrient breakdown and traffic light signals.

Participants rated the importance of: the naturalness of their food to be moderately important the price of their food to be moderately important the importance of the nutrition and health benefits of their food to be a little important the importance of emotional fulfillment from their food to be a little important the importance of familiarity of their food to be a little to not very important the importance of environmental factors related to their food to be a little important the importance of convenience of their food to be moderately important the importance of their food to appease their senses to be moderately important

INTERVENTION ASSESSMENT:

The participants were provided with the corresponding nutrition information for each item on the menu, including the use of traffic light labeling to aid in understanding the information.

They completed their menu selection surveys before and after they selected their meal. Their responses were quantified to see if the nutrition information affected their meal

selection. The reasoning behind food selection was analyzed from before and after the participants

were given the nutrition information to see if it influenced their decision. Furthermore, comparisons between food selection from before and after they were given

the nutrition information were made to see if more participants picked healthier options.  

INTERVENTION OUTCOMES:

68% of participants actually selected the food items that they had intended to eat.

From the group of participants that selected different food than what they had intended, 50% of those participants picked a less healthy food option.

From the group of participants that selected different food than what they had intended, 50% of those participants picked a healthier option.

From the group of participants that selected different food than what they had intended, 0% of those participants picked a different option which was neither better nor worse in healthfulness.

INTERVENTION OUTCOMES:

The following is based on the reasoning’s behind participants’ food choice. The reasoning’s are based on a scale of importance; ranging from not at all important to a little important, then moderately important and finally very important. Many of these reasons have not seen any or much change when provided with the nutrient breakdown and traffic light signals.

Participants rated the importance of: the naturalness of their food to be moderately important the price of their food to be moderately important the importance of the nutrition and health benefits of their food to be moderately important the importance of emotional fulfillment from their food to be a little important the importance of familiarity of their food to be not at all important the importance of environmental factors related to their food to be a little important the importance of convenience of their food to be moderately important the importance of their food to appease their senses to be moderately important

INTERVENTION OUTCOMES:

72% of the participants claimed to have noticed the nutrition information provided on the survey menu.

Out of the 72% of the participants that noticed the nutrition information, 85% of the participants claimed that the provided nutrition information influenced their food choice decision.

78% of the participants claimed that they noticed the red, yellow, and green traffic light labels on the survey menu.

Out of the 78% of the participants that noticed the traffic light labels, 79% of the participants claimed that the labels influenced their food choice decision.

RESULTS:

Selected intended Selected differently - unhealthy Selected differently - healthy Selected differently 0

10

20

30

40

50

60

70

80

Comparing Intention Outcomes

Baseline Intervention Differences

RESULTS:

Natural Price Health & Nutrition Emotional Familiarity Environmental Convenience Sensory 05

10152025303540

Baseline

Intervention

Differences

Reasons Behind Food Choice

Baseline Intervention Differences

RESULTS:

Noticed Info on Menu Noticed Traffic Light Labels65

70

75

80

85

Noticed Nutrition Info.

Nutrition Info Influenced

Nutrition Labels Provided

Noticed Nutrition Info. Nutrition Info Influenced

CONCLUSION:

After the intervention all of the participants chose the food item they intended, this may be due to the participants being cued to provide more thought behind their food choice.

After the intervention the top reason behind food choice was for nutrition and health reasons, closely following with sensory appeals, convenience and naturalness, which may be due to the participants being cued to think more about nutrition.

A larger percentage of participants claimed to have been influenced by the nutrition information than the traffic light labels.

Providing nutrition information is not enough to observe behavior change, it is important to address all the constructs behind behavior intentions (Campbell et al., 2008; Cialdin et al. 1991).

The results of the intervention may have had a bigger impact if the participants were offered nutrition education lessons to go along with menu labeling, it is recommended for future interventions to provide some education (Ajzen, 1991).

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