Elsevier

Health Policy

Volume 90, Issue 1, April 2009, Pages 73-80
Health Policy

From the point-of-purchase perspective: A qualitative study of the feasibility of interventions aimed at portion-size

https://doi.org/10.1016/j.healthpol.2008.07.006Get rights and content

Abstract

Objectives

Food portion-sizes might be a promising starting point for interventions targeting obesity. The purpose of this qualitative study was to assess how representatives of point-of-purchase settings perceived the feasibility of interventions aimed at portion-size.

Methods

Semi-structured interviews were conducted with 22 representatives of various point-of-purchase settings. Constructs derived from the diffusion of innovations theory were incorporated into the interview guide. Each interview was recorded and transcribed verbatim. Data were coded and analysed with Atlas.ti 5.2 using the framework approach.

Results

According to the participants, offering a larger variety of portion-sizes had the most relative advantages, and reducing portions was the most disadvantageous. The participants also considered portion-size reduction and linear pricing of portion-sizes to be risky. Lastly, a larger variety of portion-sizes, pricing strategies and portion-size labelling were seen as the most complex interventions. In general, participants considered offering a larger variety of portion-sizes, portion-size labelling and, to a lesser extent, pricing strategies with respect to portion-sizes as most feasible to implement.

Conclusions

Interventions aimed at portion-size were seen as innovative by most participants. Developing adequate communication strategies about portion-size interventions with both decision-makers in point-of-purchase settings and the general public is crucial for successful implementation.

Section snippets

Background

Overweight and obesity prevalence is drastically increasing worldwide [1]. Overweight is a major risk factor for chronic diseases such as cardiovascular diseases or diabetes mellitus type 2. Overweight and obesity have a considerable impact on individual lives, in addition to having a significant societal and economic impact [2].

The obesogenic environment in which we live is making a considerable contribution to the population's weight gain [3]. One of the main factors underlying the current

Participants and recruitment procedure

Semi-structured interviews were conducted with a purposive sample consisting of 22 representatives of a diverse group of Dutch point-of-purchase settings. Eight participants represented a worksite cafeteria organization, five participants spoke on behalf of fast-food restaurants, four participants represented organizations that cater to consumers in transit (e.g. a motorway restaurant), two participants represented cinema catering corporations, two participants represented the Dutch trade

Corporate responsibility for healthy consumption patterns

Many participants acknowledged that point-of-purchase settings have a responsibility in promoting healthy nutrition, which was also described in terms of responsible entrepreneurship. Participants saw their companies’ role as proactive and facilitating (mainly by providing healthy food options and information) in order to make the healthy choice the easy choice.

Portion-size policy

Most participants stated that their companies did not have a clear policy with respect to portion-sizes. In cases where they did have a

Discussion

To summarize the results, it appeared that obesity awareness was widely prevalent among the participants. The respondents also indicated that, from the perspective of responsible entrepreneurship, their companies were willing to play an active role in combating this societal problem. Of course, this willingness was subject to the condition that any such intervention would not harm commercial interests. Furthermore, in spite of the companies’ involvement with obesity, controlling portion-sizes

Conclusions

Our study shows that most interventions aimed at portion-size can be considered innovative for the majority of the companies represented. Nonetheless, participants expressed favourable attitudes towards offering a larger variety of portion-sizes and portion-size labelling. Further, worksite cafeteria organizations seemed open to pricing strategies with respect to portion-sizes. As both portion-size labelling and pricing strategies related to portion-size have yet to be implemented, both

Acknowledgements

We would like to thank the 22 point-of-purchase representatives that participated in our study. Further, we would like to thank the members of the project advisory committee that is allied to this research project. This study was funded by ZonMW (project number: 6130.0033).

References (32)

  • R. Sturm

    The effects of obesity, smoking, and drinking on medical problems and costs

    Health Affairs

    (2002)
  • S.A. French et al.

    Environmental influences on eating and physical activity

    Annual Review of Public Health

    (2001)
  • K. Glanz et al.

    Healthy nutrition environments: concepts and measures

    American Journal of Health Promotion

    (2005)
  • Brug J, Van Lenthe F: Environmental determinants and interventions for physical activity, nutrition and smoking: A...
  • K. Glanz et al.

    Environmental and policy approaches to cardiovascular disease prevention through nutrition: opportunities for state and local action

    Health Education Quarterly

    (1995)
  • B.A. Swinburn et al.

    Diet, nutrition and the prevention of excess weight gain and obesity

    Public Health Nutrition

    (2004)
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