Abstract
There is some evidence from laboratory-based studies that descriptive social-norm messages are associated with increased consumption of vegetables, but evidence of their effectiveness in real-world settings is limited. In two observational field studies taking an ecological approach, a vegetable-related social norm (e.g. “Did you know that most students here choose to eat vegetables with their meal?”), and a health message (e.g. “Did you know that students who choose to eat vegetables have a lower risk of heart disease?”) were displayed in two different student canteens. Purchases were observed during three stages: baseline, intervention (when the posters were displayed) and immediate post-intervention (when the posters had been removed). Study 1 (n = 7598) observed the purchase of meals containing a portion of vegetables and Study 2 (n = 4052) observed the purchase of side portions of vegetables. In Study 1, relative to baseline, the social-norms intervention was associated with an increase in purchases of vegetables (from 63% to 68% of meals; OR = 1.24, CI = 1.03–1.49), which was sustained post-intervention (67% of meals; OR = 0.96, CI = 0.80–1.15). There was no effect of the health message (75% of meals at baseline, and 74% during the intervention; OR = 0.98, CI = 0.83–1.15). In Study 2, relative to baseline, there was an effect of both the social norm (22.9% of meals at baseline, rising to 32.5% during the intervention; OR = 1.62, CI = 1.27–2.05) and health message (rising from 43.8% at baseline to 52.8%; OR = 0.59, CI = 0.46-0.75). The increase was not sustained post-intervention for the social norm intervention (22.1%; OR = 0.59, CI = 0.46-0.75), but was sustained for the health intervention (48.1%; OR = 0.83, CI = 0.67–1.02). These results support further testing of the effectiveness of such messages in encouraging healthier eating and indicate the need for larger-scale testing at multiple sites using a randomised-controlled design.
Highlights
Low levels of fruit and vegetable consumption have been associated with an increased risk of a variety of diseases, including cardiovascular disease, certain cancers and stroke (Aune et al, 2017)
Study 1 explored whether introducing a social-norm message or a health message in a student canteen setting was associated with increased purchase of meals containing vegetables
We found that the introduction of the social-norm posters was associated with a significant increase in the proportion of meals purchased containing vegetables, which was sustained in the post-intervention stage
Summary
Low levels of fruit and vegetable consumption have been associated with an increased risk of a variety of diseases, including cardiovascular disease, certain cancers and stroke (Aune et al, 2017). The World Health Organisation reported insufficient fruit and vegetable intake as a significant contributing factor for 2.8% of deaths globally (WHO, 2002). There have been a number of attempts to encourage the general public to increase consumption of fruit and vegetables, including long-running campaigns, but there has been little change in reported consumption over the last decade (Bates et al, 2014). Appetite 132 (2019) 122–130 public-health campaigns inadvertently encourage the behaviour they are trying to reduce (Byrne & Hart, 2009; Cho & Salmon, 2007). Attention has shifted towards other ways in which individuals can be supported in making healthier dietary choices, in particular, through utilising social processes
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