A social norms approach to encourage healthier eating

Lead Research Organisation: University of Birmingham
Department Name: School of Psychology

Abstract

Obesity is major current health concern and encouraging healthier eating is a national and global priority. However, making healthful food choices is not easy in an environment in which high calorie foods are all too easily available and highly visible. Psychological research has demonstrated that how we behave is strongly influenced by our perceptions of how other people behave in similar situations and by the opinions of others about what is appropriate behaviour in a given context. In relation to eating behaviour, people look to others as a guide for how much to eat and the presence of other people in eating situations can guide food selection. This suggests that one way of encouraging healthier eating would be to provide information about the healthy eating habits of others. This approach has been used successfully to reduce unhealthy consumption of alcoholic drinks but has yet to be applied to eating behaviour. To address this, and to provide evidence to help develop a new intervention to promote healthier eating, we will conduct experiments in which we will first expose people to posters and flyers that provide information about the healthy eating behaviour of others and then we will assess actual food selection in a simulated café environment. We predict that we can promote healthier food selection in these experiments, and then we will implement the most effective strategy in a catering outlet. The effect on actual food purchases of employees at the University of Birmingham will be assessed. These studies fit under ESRC strategic priority on health and wellbeing and will advance our understanding of the role of social norms in changing health behaviours and provide a basis for novel healthy eating interventions.

Planned Impact

This project will benefit academic researchers particularly those in the area of health and social psychology. Groups in the UK and in the USA and elsewhere conduct research on this and related-topics, so they are likely to benefit from this research. The research will also contribute to the development and wider adoption of novel methods based on social norm approaches to increase healthy behaviours. The research will contribute to the training of a skilled researcher with wide knowledge and expertise in both experimental studies and interventions. The results will also be of interest to health professionals and policy makers as well as the general public. Economic and societal impacts include improvements in health and well-being. Given the health costs associated with unhealthy eating patterns it is important to explore new avenues for improving the Nation's diet. Wide dissemination of the results (see pathways to impact plan) will ensure that a range of stakeholders are reached and beneficiaries of this project are not be limited to those in the UK.
 
Description This project investigated the effect of providing information about how others eat on the purchase and consumption of vegetables in both laboratory and in field settings (restaurants). We have reported new data to support the development of large scale social norm based interventions to encourage healthier eating.

In a series of lab based studies we established that that exposure to a novel "liking norm" message (conveying how much other people enjoy eating vegetables) increased the selection and intake of broccoli from a buffet by participants who were low habitual consumers of vegetables (a group who would most benefit from increasing their vegetable intake but who have been hard to reach with traditional healthy eating campaigns). In the same study, we also established that the liking norm was effective in increasing broccoli intake even when there was a delay between exposure to the message and selection at the buffet, suggesting that the effects of social message exposure persists beyond initial exposure, for at least 24 h. The results of two online studies provided new evidence that exposure to descriptive norm messages is effective in both increasing intentions to consume more vegetable intake and decreasing intentions to decrease "junk food" intake, especially when participants strongly identify with the norm referent group. We also found that for University students, there is a wide gap between the perception of how other students eat and how they actually report eating. Students believe that others eat fewer portions of fruit and vegetables but more portion of "Junk" food than they themselves do. Furthermore, we found that longitudinal changes in the perception of the norm predicted reported intake 12 months later, suggesting that correction of misperceptions about the eating habits of others may underlie, at least in part, the effects of social norm messages on eating.

We also conducted an intervention study in a commercial workplace setting (three sites across the UK) using similar norm based messages conveying that most people in the restaurant eat vegetables with their lunch. We found that exposure to the social norm messaging was associated with increased purchases of meals with vegetables. In two follow on studies in University canteens, we found that exposure to social norm messages was associated with increased purchases of both meals containing vegetables and vegetable side dishes.

Taken together, these results suggest that it is feasible to use social norm messages in restaurant settings and provide a firm basis for future larger scale trials. Importantly, the project has enabled collaboration with commercial companies on healthy eating interventions and led to a new project in conjunction with the NHS.
Exploitation Route Our findings could be further translated into large scale healthy eating interventions to be used in the workplace or educational setting or commercial canteens. The next step would be to conduct multi-site randomized controlled trials of the effects of social norm based healthy eating messages in such settings.
Sectors Agriculture, Food and Drink

 
Description The findings have been used in two areas: development of novel food labels by a food company and the development of an intervention to increase uptake of flu vaccination in healthcare workers. In the case of food labels, our work on social norms and eating influenced the development of front of pack labels aimed at to encourage healthier food purchasing decisions (Zandstra, E. H., Carvalho, Á. H., & Van Herpen, E. (2017). Effects of front-of-pack social norm messages on food choice and liking. Food quality and preference, 58, 85-93). We also collaborated with a hospital to design a social norms intervention that led to a significant increase in the uptake of flu vaccinations by health care workers over and above the usual approach to encouraging vaccination. The intervention has been evaluated and further funds are being sought to undertake a larger evaluation. We are also now working with partner organisations to implement social norms interventions in a commercial environment to encourage healthier eating.
First Year Of Impact 2017
Sector Agriculture, Food and Drink,Healthcare
Impact Types Policy & public services

 
Description CHERISH-DE secondment fund
Amount £2,000 (GBP)
Organisation Swansea University 
Sector Academic/University
Country United Kingdom
Start 09/2017 
End 03/2018
 
Description CH&Co 
Organisation C H & Co Ltd
Country United Kingdom 
Sector Private 
PI Contribution We conducted research studies in the restaurants that are run by the company
Collaborator Contribution The company allowed us to use their restaurants to conduct the studies
Impact Thomas, J. M., Ursell, A, Robinson, E. L., Aveyard, P. Jebb, S. Herman, C. P. & Higgs, S. Using a descriptive norm message to increase vegetable selection in a workplace restaurant setting. Health Psychology, In press.
Start Year 2014
 
Description Developing a social norm intervention 
Organisation University of Oxford
Country United Kingdom 
Sector Academic/University 
PI Contribution We advised on the implementation of an intervention based on our social norms research that was designed to promote healthier food purchases
Collaborator Contribution Working with a commercial partner to implement the intervention
Impact None yet
Start Year 2019
 
Description Development of a social norms intervention 
Organisation Cancer Research Campaign
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution We advised on the implementation of an intervention based on our social norms research that was designed to promote healthier food purchases
Collaborator Contribution Working with a commercial partner to implement the intervention
Impact No outcomes yet
Start Year 2019
 
Description Neath Port Talbot Hospital 
Organisation Swansea University
Country United Kingdom 
Sector Academic/University 
PI Contribution We are conducting a feasibility study on the use of social norm information to increase uptake of the flu vaccine among health care workers.
Collaborator Contribution We have secured some funding for this project from the CHERISH-DE centre at Swansea University
Impact The study will start soon so not outputs as yet. It is a multi-disciplinary collaboration involving digital technology, psychology and the NHS.
Start Year 2017
 
Description Pilot research project 
Organisation Livefit
Country United Kingdom 
Sector Private 
PI Contribution We designed a pilot research project to asses the influence of social norms on commitment to exercise
Collaborator Contribution The partner allowed us to have access to personal training networks
Impact No outputs as yet
Start Year 2016
 
Description Pilot research project 
Organisation Starbucks
Country United Kingdom 
Sector Private 
PI Contribution We conducted some pilot research on the potential for using social norms to encourage healthier purchases
Collaborator Contribution The partners assisted with the production of materials for the study and access to stores
Impact No outputs yet
Start Year 2016
 
Description British Science Festival 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The 'Foodscape Walk' invited people to think about their environment in terms of food; rather than looking across the landscape, they looked across the foodscape. When we stop and look around us with food in mind, it is clear that our environment is littered with information about food, prompts about food and food itself. During the walk they discussed how this 'busy' foodscape might influence the own eating and, in turn, the body weight. Professor Suzanne Higgs from the University of Birmingham outlined some influences on foods choice that you might find surprising and discussed some new strategies that might help to encourage healthy eating. It was a sold out event for 30 members of the public. There was lots of discussion and the talk featured in the highlights of the festival (https://storify.com/SwanseaUni/british-science-festival-2016)
Year(s) Of Engagement Activity 2016
URL https://storify.com/SwanseaUni/british-science-festival-2016
 
Description Group web page 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Hits on web site

We were complemented on the clarity of the description of the research for a lay audience.
Year(s) Of Engagement Activity 2014,2015
URL http://www.birmingham.ac.uk/research/activity/psychology/healthier-eating/index.aspx
 
Description Interview for BBC 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact I was interviewed for a piece on BBC futures on social influences on eating
Year(s) Of Engagement Activity 2019
URL http://www.bbc.com/future/story/20190520-how-your-friends-change-your-habits---for-better-and-worse
 
Description Masterclass for year 11 pupils on psychology of eating 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact The students asked lots of question during and after the masterclass.

The evaluation of the masterclass was very positive and many pupils reported being more interested in study psychology at University.
Year(s) Of Engagement Activity 2012,2013,2014,2015
 
Description Masterclass to schools 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact 120 pupils attended a masterclass at the research organisation which included discussion and questions and the evaluation reported increased interest in the research area and interest in studying at University
Year(s) Of Engagement Activity 2016
 
Description Podcast 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Suzanne Higgs was interviewed about her research for the award winning water cooler neuroscience podcast
Year(s) Of Engagement Activity 2019
URL https://watercoolerneuroscience.co.uk/podcast/s1-ep4-suzanne-higgs-social-vs-personal-appetites
 
Description Presentation University of Bristol Social norms and healthy eating 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact There was lots of discussion about the potential for using social norms in health interventions.

I was asked for a copy of my presentation to be circulated to the group
Year(s) Of Engagement Activity 2014
 
Description Presentation at Paul Bocuse Institute France 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Talk sparked questions and discussion afterwards

Culinary practitioners became aware of the research
Year(s) Of Engagement Activity 2014
 
Description Presentation at University of Sussex 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact There was discussion during and after the presentation

One of the audience was interested in working with me.
Year(s) Of Engagement Activity 2014
 
Description Presentation to a company 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact A presentation on our research project was made to a multinational company (European HQ in London), which sparked interest in a collaboration.
Year(s) Of Engagement Activity 2016
 
Description Presentation to company, Oxford UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The talk resulted in a collaboration

The company was more informed about the research and its implications for the business and employee health
Year(s) Of Engagement Activity 2014
 
Description Public event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Members of the public attended a psychology event at Birmingham library and we had a specific stand on our research

Dissemination of research
Year(s) Of Engagement Activity 2013,2014
 
Description School visit 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact 12 pupils attended a session delivered at the school. Feedback from the visit suggested that interest in the subject area had increased.
Year(s) Of Engagement Activity 2016
 
Description School visit (school from London) 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact around 100 pupils from a school in London attended session at the University of Birmingham that I delivered. Feedback suggested an increased interest in the subject area.
Year(s) Of Engagement Activity 2016
 
Description School visit to talk about research 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact I visited a school in Shropshire to talk to year 12 pupils about my research during an A level psychology class.
Year(s) Of Engagement Activity 2016
 
Description Seminar at the University of Hull 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact There were many questions and lots of discussion after the talk

People who were not aware of the research findings were informed of our activities.
Year(s) Of Engagement Activity 2015
 
Description Visit to Mondalez 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Discussions around product development

After the talk I was asked to provide more information on the research
Year(s) Of Engagement Activity 2014
 
Description podcast 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact We created podcasts of interviews with the lead researchers/students on the project
Year(s) Of Engagement Activity 2019
URL https://eatingbehaviourrg.wordpress.com/research-podcasts/