Melbourne School of Psychological Sciences - Research Publications

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    Can counter-advertising exposing alcohol sponsorship and harms influence sport spectators' support for alcohol policies? An experimental study
    Scully, M ; Dixon, H ; Brennan, E ; Niederdeppe, J ; O'Brien, K ; Pettigrew, S ; Vandenberg, B ; Wakefield, M (BMC, 2023-02-27)
    BACKGROUND: Exposure to alcohol advertising and sponsorship through elite sport is associated with harmful use of alcohol. Owing to strong financial and cultural ties between alcohol and sport in Australia, policy action to restrict alcohol sport sponsorship is unlikely to occur without strong public support for change. This study tested whether exposure to counter-advertising exposing industry marketing of harmful products-a technique shown to be effective in tobacco control-promotes higher support for policy change and less favourable beliefs about the alcohol industry among sport spectators. METHODS: A sample of 1,075 Australian adults aged 18-49 years who planned to watch an National Rugby League (NRL) State of Origin series game, featuring prominent alcohol sponsorship, was recruited through an online panel and randomly assigned to one of three conditions: control (neutral advertisement); counter-advertisement exposing alcohol harms; counter-advertisement exposing alcohol sponsorship and harms. Participants completed a pre-test questionnaire and viewed their assigned counter-advertisement multiple times in the 5-7 days before the NRL game. Within four days of watching the game, participants completed post-test measures. RESULTS: Compared to both the control advertisement and the counter-advertisement exposing alcohol harms, participants who viewed the counter-advertisement exposing alcohol sponsorship and harms were significantly more likely to indicate support for each of four policies aimed at restricting sports-related alcohol marketing, including the complete removal of alcohol sponsorship from sport (51% vs. 32% and 37%). They were also significantly less likely to agree with statements such as "alcohol companies should be allowed to sponsor sport since their products are legal" (39% vs. 63% and 60%) and significantly less likely to report liking alcohol companies in general (38% vs. 59% and 54%). There were no significant differences in policy support or industry beliefs between participants who saw the counter-advertisement exposing alcohol harms and those who saw the control advertisement. CONCLUSION: Counter-advertising employing messages that expose and critique the intent and impact of pervasive alcohol sponsorship in sport has potential to bolster public support for policies targeting alcohol sport sponsorship, diminish beliefs supportive of alcohol industry marketing strategies and enhance negative views of alcohol companies and their marketing practices.
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    Understanding the effectiveness of advertisements about the long-term harms of alcohol and low-risk drinking guidelines: A mediation analysis
    Brennan, E ; Schoenaker, DAJM ; Dunstone, K ; Slater, MD ; Durkin, SJ ; Dixon, HG ; Pettigrew, S ; Wakefield, MA (PERGAMON-ELSEVIER SCIENCE LTD, 2021-02)
    RATIONALE: Many people overestimate the amount of alcohol that increases their risk of harm and so may not perceive any need to change their drinking behaviour. Several countries have developed low-risk drinking guidelines, yet awareness of these guidelines remains low. Furthermore, mass media campaigns about alcohol-related harms may have limited impact if people do not perceive their current consumption as potentially harmful. Integrating drinking guidelines into media campaigns about alcohol's harms can concurrently provide drinkers with information about low-risk drinking levels and compelling reasons to comply. OBJECTIVE: Our aim was to build understanding of the effectiveness of messages about the long-term harms of drinking and low-risk drinking guidelines, by testing the mediating effects of estimates of harmful drinking levels and attitudes towards drinking alcohol on subsequent intentions and behaviours. METHOD: In an online experiment conducted in 2016, n = 1156 Australian adult monthly drinkers were randomly assigned to view advertisements for non-alcohol products (NON-ALC; control), advertisements featuring long-term harms of alcohol (LTH), or LTH advertisements plus a guideline message (LTH + G). Immediately following exposure, we measured estimates of harmful drinking levels and attitudes towards drinking alcohol. One week later, we measured intentions to drink less and behavioural compliance with the guideline. RESULTS: Compared to NON-ALC advertisements, exposure to LTH + G advertisements increased (i) the proportion of respondents who correctly estimated harmful drinking levels, which in turn, strengthened intentions to drink less (42% of the total effect was mediated), and (ii) negative attitudes, which in turn, also increased intentions to drink less (35% mediated) and behavioural compliance (24% mediated). Compared to NON-ALC, LTH advertisements increased negative attitudes, which in turn strengthened intentions to drink less (53% mediated). CONCLUSIONS: When paired with effective alcohol harm reduction television advertisements, messages promoting low-risk drinking guidelines can increase drinkers' intentions to reduce their alcohol consumption and compliance with low-risk drinking guidelines.
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    Health warnings promote healthier dietary decision making: Effects of positive versus negative message framing and graphic versus text-based warnings
    Rosenblatt, DH ; Bode, S ; Dixon, H ; Murawski, C ; Summerell, P ; Ng, A ; Wakefield, M (Elsevier, 2018-08-01)
    Food product health warnings have been proposed as a potential obesity prevention strategy. This study examined the effects of text-only and text-and-graphic, negatively and positively framed health warnings on dietary choice behavior. In a 2 × 5 mixed experimental design, 96 participants completed a dietary self-control task. After providing health and taste ratings of snack foods, participants completed a baseline measure of dietary self-control, operationalized as participants' frequency of choosing healthy but not tasty items and rejecting unhealthy yet tasty items to consume at the end of the experiment. Participants were then randomly assigned to one of five health warning groups and presented with 10 health warnings of a given form: text-based, negative framing; graphic, negative framing; text, positive framing; graphic, positive framing; or a no warning control. Participants then completed a second dietary decision making session to determine whether health warnings influenced dietary self-control. Linear mixed effects modeling revealed a significant interaction between health warning group and decision stage (pre- and post-health warning presentation) on dietary self-control. Negatively framed graphic health warnings promoted greater dietary self-control than other health warnings. Negatively framed text health warnings and positively framed graphic health warnings promoted greater dietary self-control than positively framed text health warnings and control images, which did not increase dietary self-control. Overall, HWs primed healthier dietary decision making behavior, with negatively framed graphic HWs being most effective. Health warnings have potential to become an important element of obesity prevention.
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    Evaluating the influence of message framing and graphic imagery on perceptions of food product health warnings
    Rosenblatt, DH ; Dixon, H ; Wakefield, M ; Bode, S (ELSEVIER SCI LTD, 2019-10)
    Food product health warnings may be a valuable intervention strategy for helping reduce obesity rates and the negative health outcomes associated with consuming an unhealthy diet. Research into the efficacy of food product health warnings has shown promising effects on consumers’ beliefs and behaviour, but existing research has typically featured a single or limited number of simple, text-only warnings. Two studies are presented that tested the influence of text-only and text-and-graphic, positively and negatively framed health warnings on perceived efficacy, negative affect and motivation to change behaviour. Using a between-subjects design, Study 1 found that negatively framed health warnings and text-and-graphic health warnings produced more negative emotional responses than positively framed and text-only health warnings. Study 2 then featured the highest rated message topics from Study 1. Using a within-subjects design, Study 2 found that participants rated text-and-graphic health warnings as more effective than text-only warnings, and negatively framed warnings as more effective than positively framed warnings, though all warning groups scored above the scale mid-point on perceived efficacy. Negatively framed warnings produced stronger negative emotional responses, while positively framed warnings produced stronger feelings of motivation to change behaviour. Results indicate that food product health warnings were perceived as capable of effectively promoting behavioural change. While negatively framed warnings were seen as most effective, positively framed warnings may also be effective, possibly through a different persuasive pathway.
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    General and specific graphic health warning labels reduce willingness to consume sugar-sweetened beverages
    Schubert, E ; Smith, E ; Brydevall, M ; Lynch, C ; Ringin, E ; Dixon, H ; Kashima, Y ; Wakefield, M ; Bode, S (ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2021-06-01)
    Sugar-sweetened beverage (SSB) consumption is associated with obesity and other severe negative health consequences. The present study examined the effectiveness of two types of health warning labels (HWLs) in modulating dietary choices for SSBs: specific HWLs, presenting health consequences associated with consuming SSBs, and general HWLs, presenting health consequences of an unhealthy diet and obesity. While electroencephalography (EEG) was recorded, 63 participants completed a computer-based task in which they were first randomly allocated to view either SBB-specific, general, or non-warning control HWLs. They then viewed images of a range of SSB products, varying on perceived healthiness and tastiness, and rated their willingness to consume (WTC) each one. Linear mixed-effect model analyses revealed that general and specific HWLs both decreased WTC SSBs perceived as tasty, compared to the control condition. For general HWLs, this effect was reduced for SSBs perceived to be healthy, suggesting that specific HWLs may be more effective at reducing SSB consumption. The EEG data showed that SSBs considered unhealthy elicited greater N1 amplitudes, and tasty SSBs elicited greater late positive potential (LPP) amplitudes, possibly reflecting attentional allocation and craving responses, respectively. However, no strong differences between HWL types were found. Taken together, the results suggest that graphic HWLs, both general and specific, have the potential to reduce SSB consumption, but they do not strongly modulate craving-related neural responses to SSBs.
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    Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study
    Wakefield, MA ; Brennan, E ; Dunstone, K ; Durkin, SJ ; Dixon, HG ; Pettigrew, S ; Slater, MD (WILEY, 2018-06)
    AIMS: To compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines. DESIGN: Between-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G). SETTING: Australia, 2016. PARTICIPANTS: A total of 3718 drinkers aged 18-64 years (48.5% male). MEASUREMENTS: Post-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption. FINDINGS: After exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P < 0.001) and LTH advertisements without guidelines, respectively (P = 0.019) and ALC control (STH+G, P < 0.001; LTH+G, P < 0.001) and NON-ALC control conditions (STH+G, P < 0.001; LTH+G, P = 0.011). Drinkers exposed to STH conditions were more likely to intend to reduce next-week alcohol consumption than those exposed to ALC control (both P < 0.001) and NON-ALC control conditions (STH, P = 0.001; STH+G, P < 0.001); a similar pattern was observed for intentions to avoid alcohol. Drinkers exposed to LTH conditions were also more likely than drinkers exposed to ALC or NON-ALC controls to intend to avoid and reduce alcohol in the next week. Additionally, drinkers exposed to LTH+G were more likely to intend to reduce drinking than those exposed to LTH advertisements without guidelines (P = 0.022). Response patterns for low- and high-risk drinkers by condition were similar. CONCLUSIONS: Alcohol harm television advertisements increase intentions to reduce alcohol consumption among both low- and high-risk drinkers. The addition of low-risk drinking guidelines can enhance these effects for advertisements featuring long-term harms and improve estimates of both short- and long-term harmful drinking levels.
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    Sugary drink advertising expenditure across Australian media channels 2016-2018
    Haynes, A ; Bayly, M ; Dixon, H ; McAleese, A ; Martin, J ; Chen, YJM ; Wakefield, M (WILEY, 2021-06)
    OBJECTIVE: The aim of this study was to describe advertising expenditure for sugary drinks compared with alternative cold non-alcoholic beverages (artificially sweetened beverages, plain water, plain milk) between 2016 and 2018 across Australian media channels. METHODS: Monthly estimates of advertising expenditure for non-alcoholic beverages were obtained from Nielsen Media and aggregated by product type and media. RESULTS: Total sugary drink advertising expenditure between 2016 and 2018 ($129.5M) significantly exceeded expenditure on artificially sweetened drinks ($23.26M), plain water ($14.27M), and plain milk ($31.30M). Television and out-of-home advertising accounted for the largest share of sugary drink advertising (45%, 35%). Expenditure on out-of-home advertising was more heavily dominated by sugary drinks (75%) than advertising in all media combined (65%). Sugary drink advertising peaked in warmer months and was lowest in August. Soft drinks (26%), flavoured milks (24%) and energy drinks (21%) accounted for the majority of sugary drink advertising. CONCLUSIONS: Cold non-alcoholic beverage advertising in Australian media is dominated by the advertising of sugary drinks. Implications for public health: Restricting unhealthy beverage advertising on television and out-of-home media may be most effective initially. However, comprehensive restrictions capturing a broader range of media and settings would be optimal to prevent displacement and limit advertising reach and exposure.
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    Can counter-advertising diminish persuasive effects of conventional and pseudo-healthy unhealthy food product advertising on parents?: an experimental study
    Dixon, H ; Scully, M ; Gascoyne, C ; Wakefield, M (BMC, 2020-12-25)
    BACKGROUND: To help address rising rates of obesity in children, evidence is needed concerning impacts of common forms of marketing for unhealthy child-oriented food products and the efficacy of educational interventions in counteracting any detrimental impacts of such marketing. This study aims to explore parents' responses to advertising for unhealthy children's food products that employ different types of persuasive appeals and test whether a counter-advertising intervention exposing industry motives and marketing strategies can bolster parents' resistance to influence by unhealthy product advertising. METHODS: N = 1613 Australian parents were randomly assigned to view online either a: (A) non-food ad (control); (B) conventional confectionery ad (highlighting sensory benefits of the product); (C) pseudo-healthy confectionery ad (promoting sensory benefits and health attributes of the product); (D) conventional confectionery ad + counter-ad (employing inoculation-style messaging and narrative communication elements); (E) pseudo-healthy confectionery ad + counter-ad. Parents then viewed various snacks, including those promoted in the food ads and counter-ad. Parents nominated their preferred product, then rated the products. RESULTS: Exposure to the conventional confectionery ad increased parents' preference for the advertised product, enhanced perceptions of the product's healthiness and reduced sugar content and boosted brand attitude. Exposure to the pseudo-healthy confectionery ad increased parents' preference for the advertised product, and enhanced perceptions of healthiness, fibre content and lower sugar content. The counter-ad diminished, but did not eliminate, product ad effects on parents' purchasing preference, product perceptions and brand attitudes. The counter-ad also prompted parents to perceive processed foods as less healthy, higher in sugar and lower in fibre and may have increased support for advertising regulation. CONCLUSIONS: Exposure to unhealthy product advertising promoted favourable perceptions of products and increased preferences for advertised products among parents. Counter-advertising interventions may bolster parents' resistance to persuasion by unhealthy product advertising and empower parents to more accurately evaluate advertised food products.
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    Competing with big business: a randomised experiment testing the effects of messages to promote alcohol and sugary drink control policy
    Scully, M ; Brennan, E ; Durkin, S ; Dixon, H ; Wakefield, M ; Barry, CL ; Niederdeppe, J (BMC, 2017-12-28)
    BACKGROUND: Evidence-based policies encouraging healthy behaviours are often strongly opposed by well-funded industry groups. As public support is crucial for policy change, public health advocates need to be equipped with strategies to offset the impact of anti-policy messages. In this study, we aimed to investigate the effectiveness of theory-based public health advocacy messages in generating public support for sugary drink/alcohol policies (increased taxes; sport sponsorship bans) and improving resistance to subsequent anti-policy messages typical of the sugary drink/alcohol industry. METHODS: We conducted a two-wave randomised online experiment assigning Australian adults to one of four health policies (sugary drink tax; sugary drink industry sports sponsorship ban; alcohol tax; alcohol industry sports sponsorship ban). Within each health policy, we randomised participants to one of five message conditions: (i) non-advocacy based message about the size and seriousness of the relevant health issue (control); (ii) standard pro-policy arguments alone; (iii) standard pro-policy arguments combined with an inoculation message (forewarning and directly refuting anti-policy arguments from the opposition); (iv) standard pro-policy arguments combined with a narrative message (a short, personal story about an individual's experience of the health issue); or (v) standard pro-policy arguments combined with a composite inoculation and narrative message. At time 1, we exposed participants (n = 6000) to their randomly assigned message. Around two weeks later, we re-contacted participants (n = 3285) and exposed them to an anti-policy message described as being from a representative of the sugary drink/alcohol industry. Generalised linear models tested for differences between conditions in policy support and anti-industry beliefs at both time points. RESULTS: Only the standard argument plus narrative message increased policy support relative to control at time 1. The standard argument plus narrative and standard argument plus inoculation messages were effective at increasing resistance to the persuasive impact of anti-policy messages relative to control at time 2. CONCLUSIONS: Dissemination of advocacy messages using inoculation or narrative components can help strengthen public resistance to subsequent anti-policy messages from industry groups.
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    Population-based evaluation of the 'LiveLighter' healthy weight and lifestyle mass media campaign
    Morley, B ; Niven, P ; Dixon, H ; Swanson, M ; Szybiak, M ; Shilton, T ; Pratt, IS ; Slevin, T ; Hill, D ; Wakefield, M (OXFORD UNIV PRESS, 2016-04)
    The Western Australian (WA) 'LiveLighter' (LL) mass media campaign ran during June-August and September-October 2012. The principal campaign ad graphically depicts visceral fat of an overweight individual ('why' change message), whereas supporting ads demonstrate simple changes to increase activity and eat healthier ('how' to change message). Cross-sectional surveys among population samples aged 25-49 were undertaken pre-campaign (N= 2012) and following the two media waves (N= 2005 and N= 2009) in the intervention (WA) and comparison state (Victoria) to estimate the population impact of LL. Campaign awareness was 54% after the first media wave and overweight adults were more likely to recall LL and perceive it as personally relevant. Recall was also higher among parents, but equal between socio-economic groups. The 'why' message about health-harms of overweight rated higher than 'how' messages about lifestyle change, on perceived message effectiveness which is predictive of health-related intention and behaviour change. State-by-time interactions showed population-level increases in self-referent thoughts about the health-harms of overweight (P < 0.05) and physical activity intentions (P < 0.05). Endorsement of stereotypes of overweight individuals did not increase after LL aired. LL was associated with some population-level improvements in proximal and intermediate markers of campaign impact. However, sustained campaign activity will be needed to impact behaviour.