National Institute for Consumer Research
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Background: Early access of medicines occurs with an uncertainty in the evidence even higher than the one experienced when price and reimbursement status is negotiated. Our aim is discussing the role of managed entry agreements (MEA) within early access programs (EAP) in Italy. Methods: The discussion relied on a Focus Group, participated by twelve experts, including clinicians and representatives of regulatory authorities, regional and local pharmaceutical departments, pharmaceutical companies, and an association advocating for active citizenship. Results: The Focus Group emphasised that the topic under discussion should be embedded into a more general reform of EAP in Italy. The 648 List mostly includes mature products and indications that are rarely launched into the market afterwards. The 5% Fund is affected by an important administrative burden uncertainty of the timing of reimbursement. Conclusions: Starting from the discussion on MEA and EAP, the Focus Group recommended a new legislation better regulating EAP, that early access concerns specific classes of medicines selected on the grounds of the need to guarantee a rapid access and to collect real world data, that early access can be accompanied by outcome-based and population-based MEA, and that MEA are embedded into the subsequent price and reimbursement negotiation.
This article addresses the issue of the profitability of Food Quality Scheme (FQS) products as compared to reference products, which are defined as analogous products without quality label. We approach this question by taking into account the level of the value chain (upstream, processing, and downstream), the sector (vegetal, animal, seafood) and the type of FQS (PGI, PDO, Organic). We collected original data for several products produced in selected European countries, as well as in Thailand and Vietnam. Comparisons depending on value chain level, sector and FQS are possible by using two comparable indicators: price premium and net price premium (including cost differential). The following principal conclusions were reached: 1) Price is higher for FQS products than for the reference products, regardless of the production level, the type of FQS or the sector; 2) Price premiums generated by FQS do not differ along the value chain, nor between sectors (vegetal, animal or seafood/fish); 3) Price premium for organic products is significantly higher than for PGI products, and this conclusion holds at upstream and processing levels, taking into account the costs directly related to production; 4) All organic products and almost all PDO and PGI products analysed benefit from a positive quality rent; 5) At upstream level and processing level, the relative weight of intermediate consumption in the cost structure is lower for organic products than for reference products.
In this paper, we test to what extent Food Quality Schemes (FQS, including Geographical Indications and organic products) contribute to the social and economic sustainability of farmers and regions through employment and education. Through employment, FQS may counter the urban migration trend affecting rural regions, and help retain economic and social capital in the local region. Indeed, as FQS are often small and specialised sectors, the economic inefficiency of such businesses may translated into greater employment and social sustainability. Separately , by requiring a higher-level of quality and hence skills, FQS may encourage greater local educational attainment or skilled immigration. To test these propositions , we analyse the employment and educational outcomes of 25 FQS. Our results show that the FQS products examined have a 13% higher labour usage (labour-to-production ratio) compared to reference products, indicating that they provide greater employment. Additionally, wage levels are 32% higher in FQS compared to references. Despite providing greater employment and higher wages, profitability of FQS (i.e. how much turnover/profit is generated per employee) is nevertheless 32% higher for FQS compared to reference products, due to the ability to attract higher product prices. Finally, there is no clear link between FQS and greater (or lower) education attainment in the supply chain. Overall, our results suggest that FQS can provide a strong contribution to local employment, employee income and business profits, strengthening the social and economic sustainability of producers and regions.
This paper estimates the foodmiles (embedded distances) and transport-related carbon emissions of 27 Food Quality Scheme (FQS) products – Protected Designation of Origin (PDO), Protected Geographical Indications (PGI) and organic – and their reference products. It goes further than the existing literature by adopting a value chain perspective, instead of the traditional consumer perspective, and focusing on FQS products. The same methodology is applied across all the case studies. The article specifically investigates the determinants of differences between FQS and their references. FQS products travel significantly shorter distances (−30%) and generate significantly lower transport-related emissions (−23%) than conventional food products. The differences are even greater for vegetal and organic products. The relationship between distance and transport-related emissions is not exactly proportional and highlights the importance of transport modes and logistics, in particular for exports and imports. Finally, we stress the importance of the spatial distribution of the different stages in the value chains (e.g. production, processing). PDO technical specifications delimit a geographical area for production and processing, thereby limiting distances and transport-related emissions compared to conventional food products, but also compared to other types of FQS.
Objective: Health services should arguably be concerned about the financial situation of patients since health problems can cause financial concerns, which in turn can cause health problems. In this study, we explored the role of the general practitioner (GP) as a potential early discoverer of financial problems who can refer at-risk patients to financial counselling services. Design: A collaborative health service research experiment. For four weeks, GPs asked their patients predefined questions about financial concerns and health, by anonymous data mapping. GPs shared their experiences with the researchers after the experiment. Setting: One GP office in Norway. Subjects: A total of 565 patients were included in data mapping by 8 GPs. Main outcome measures: Patient prevalence data and GPs experimental data of patients’ health problems that caused financial concerns and financial concerns that affected patients’ health. Results: Of 565 GP patients, 11% (n = 63) indicated that they had health problems causing them financial concerns, or vice versa; 9% of patients reported health problems causing financial concerns and 8% of patients reported financial concerns that affected their health. Through the data mapping experiment GPs became aware of financial concerns of their patients and by this expanded and improved their therapeutic toolbox. Several months after the experiment the GPs reported that more patients received financial counselling since the GPs asked their patients about financial problems more often than before and because the patients had heard that GPs cared about such problems. Conclusion: Our results suggest that GPs can be early discoverers of financial problems interacting with their patients’ health. When there are no clear medical explanations for the health problems that prompted the consultation, the best therapy may thus be financial counselling. • Key points • Many people live on the edge of financial ruin and struggle to keep track of their finances, but limited research exists that investigates associations between finance and health. • In a collaborative health services research experiment 11% of the patients at a Norwegian GP office had health problems that caused them financial concerns, or vice versa. • GPs found it helpful to ask patients about their financial concerns when no clear medical explanations for their health problems was found. Then free financial counselling services could be offered.
A circular bioeconomy has become a global aspiration for governments in Europe and around the globe. This article pursues research questions concerning concrete innovations aiming to create bioeconomic transition options in Norway and presents results from a transdisciplinary investigation of Norwegian food industry cases involving processing of fish, meat, fruit, and vegetable co-streams aiming to capture or even increase use and value of residues from processing. It shows that while objectives of avoiding food losses and transforming co-streams to new products of higher value characterizes the poultry industry case and part of the ´blue´ sector, challenges remain particularly in the ´whitefish´ area where - also at the global level - a high share of fish resources ends as rest raw materials, i.e. not fully utilised. The investigation targeted strategic cases of innovations enabling alternative uses of co-streams: automation and scanning technologies for fractioning raw materials and co-streams into different qualities, a collection system for fish rest raw materials at sea, enzymatic hydrolysis, use of second grade vegetables for smoothies and potato peels for biodegradable plastics in the vegetable (potato) processing industries. The article shows how these innovations enable cascading and valorization of co-streams and why an upcycling potential exist as well. Its main contribution is in demonstrating feasibility of transdisciplinary research and innovative options for bioeconomic transition towards sustainability.
The textile and clothing industry is considered as one of the most polluting industries in the world. Still, the regulation of environmental hazards connected to the industry is very limited, and much responsibility is placed on the shoulders of consumers. One of the few ways that ordinary consumers can seek to influence the textile and clothing industry is through their own consumption practices and their wallet. This article departs from the discourse on sustainable consumption and the role of the consumer as an agent for change, and the article investigates the characteristics of the consumers who practice deliberate environmentally sustainable consumption of textiles and clothing. This is done through the lens of political consumption. Based on a cross-national survey conducted in five Western European countries, factors that have been found to predict general political consumption in previous research are tested on the field of textiles and clothing. The findings demonstrate both similarities and some discrepancies with previous studies of political consumption as well as significant country variations.
Surveys from societies like the USA, Canada, the UK, and France suggest that 5–15% of the population have experienced “food insecurity” in the sense of not having enough food to eat due to a lack of money or other resources. The Nordic countries are among the most affluent societies in the world and it is generally assumed that food insecurity has been eradicated due to relatively low differences in wages and well-developed social security schemes. This representative web survey of food and eating in Denmark, Finland, Norway, and Sweden indicates however that food insecurity does exist in the Nordic region. In line with research from other industrialized counters, it also suggests that women, young people, single parents, and low-income group seem more at risk of experiencing food insecurity than others. These results must be regarded as preliminary, needing to be substantiated by more comprehensive studies. Moreover, there is a need to develop or use more standardized methodologies enabling comparison across countries and mapping trends over time.
The concept of food security is often anchored in popular understandings of the challenge to produce and supply enough food. However, decades of policies for intensive agriculture have not alleviated hunger and malnutrition, with an absence of food security featuring in both economically developing and developed nations. Despite perceptions that the economic growth in advanced, capitalist societies will ensure freedom from hunger, this is not universal across so-called 'wealthy nations'. To explore the dynamics of food security in economically developed countries, this paper considers institutional approaches to domestic food security primarily through responses to poverty and welfare entitlements, and, secondarily, through food relief. Through the lens of social entitlements to food and their formation under various expressions of welfare capitalism, we highlight how the specific institutional settings of two economically developed nations, Australia and Norway, respond to uncertain or insufficient access to food. Whilst Norway's political agenda on agricultural support, food pricing regulation and universal social security support offers a robust, although indirect, safety net in ensuring entitlements to food, Australia's neoliberal trajectory means that approaches to food security are ad hoc and rely on a combination of self-help, charitable and market responses. Despite its extensive food production Australia appears less capable of ensuring food security for all its inhabitants compared to the highly import-dependent Norway.
Despite the fact that no studies have been carried out to map the amount of unhealthy food advertising aimed at Norwegian children and adolescents, it is still widely held belief that this type of advertising is disproportionately common. As a consequence, one of the issues high on the agenda in Norway in the 2000s was the possibility of imposing restrictions on advertising for unhealthy foods to children. The purpose of this study is to contribute with a research-based foundation for implementing this health initiative by mapping food marketing in media channels widely used by children and adolescents. In sum, the study shows that the food industry spends a lot of resources to influence young consumers' eating and drinking habits. Compared with studies from USA, UK and Australia, however, there are, strong indications that there is significantly less unhealthy food advertising in Scandinavian countries. Similar to a previous Swedish study, this study shows that Norwegian children and young people were exposed to little advertising for unhealthy food products through media channels such as TV, the Internet, magazines, comics and cinemas. The study also supports critical remarks from some researchers that the extensive use of the international discourse as a political argument and recommendation for Norwegian conditions is not accurate. For the future it may be beneficial to look more closely at the relationship between advertising and health policy, and how this relationship can be further developed to improve children and young people's diet.
This article argues that, although research on children and media has provided rich knowledge on the various discursive aspects pertaining to children and media insights into children’s media practices, its regulation and how the discursive links to these practical realities is still poor. The claim is based on three observations: dominance of discourse-based research, the variability and context-dependency of meaning, and lack of attention to the embodied and situated. From these critical reflections, and by drawing on some concrete examples, the article argues that giving attention to the non-discursive aspects of children’s media practices is essential in bringing new insights to the field and suggests such attention should be brought into future research agendas. Finally, theoretical and methodological approaches that can aid researches in better addressing the complexity of practice are discussed.
This article was developed from the project ‘Valuing Norwegian Wool’ initiated by the Norwegian National Institute for Consumer Research to generate knowledge on how wool can contribute to sustainable textile consumption, and how value creation can be increased in the Norwegian wool industry. The article will compare consumer perceptions, attitudes, practices and knowledge concerning wool as a material and as garments in Norway and in the United Kingdom, through a case study of wardrobes owned by six middle-class families. The aim is to generate knowledge about the diverse web of aspects that influence consumption of woollen garments. The wardrobe study as a method aims to include the materiality of garments in clothes research in a more direct way. Analysing the materiality in connection with the social and cultural aspects of clothes gives us a better understanding of the relations between materiality and practice.
Consumers’ decisions in the disposal phase of clothing are crucial from an environmental point of view, as they affect the lifespan of clothing, as well as the potential for reuse and recycling. This chapter discusses the effects of different end-of-life scenarios to the life cycle assessment (LCA) calculations. In doing this, examples of Norwegian consumers’ clothing use and disposal practices are used, including the channels they select, how frequently they dispose of clothing and whether there are any differences between consumer groups. Based on these results, the weaknesses of many existing LCA studies related to the use phase are discussed and improvements on gaining more realistic data are suggested. The first section of this study provides an overview of the environmental benefits of clothing recycling and reuse. This is followed by a discussion that defines disposal and how the term is used in this chapter. The statistics for the current situation in Norway for the end-of-life textiles and clothing are presented, followed by a short overview of the literature on clothing disposal practices. Then the two methods that are employed, a wardrobe study and a survey, are presented, followed by results on disposal methods and frequencies. Finally, the implications of the present study are discussed, and suggestions for policy measures and future research directions are suggested.
This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life. METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support. RESULTS: We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation. CONCLUSIONS: The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB.
Based on comparative focus group data from Norway, Denmark and England, this article asks why people take on substantial mortgages to become homeowners. It argues that financialization of the housing market has resulted in a widespread investment philosophy at the household level and changed the way people think and talk about “the home”. High levels of mortgage borrowing have become commonplace and are justified by social valuations of owner-occupation based on beliefs around freedom through homeownership. Like previous research, the study shows that homeownership offers social identity, stability and belonging. But, this is wrapped up in an investor’s language, such that the distinction between homes as socially valued living environments and homes as investment objects has become blurred. This makes it difficult – perhaps impossible – for households to assess the risks involved in home purchases.
This paper looks at how financial problems may occur among households even under favourable economic conditions. Norway is a good case for studying such processes because of its exceptionally stable economy. Based on data on debt settlements in Oslo in 1999, 2004 and 2011 the composition of debt portfolios is investigated as instances of how risk mechanisms operate and change over time. It is demonstrated that the most dangerous and expensive forms of loans and credit are allocated to the most exposed households. The analysis also suggests that during economic upturns, the potentials for a much larger and deeper problem accumulate as households borrow to invest in asset-based welfare. This raises important questions about the market, and challenges the welfare state.
This study explored parents’ and preschool personnel’s opinions on factors influencing 3–5-year-old children’s sedentary behaviors by applying the socioecological model. Four focus group interviews with preschool personnel (N = 14) and six interviews with parents (N = 17) were conducted in autumn 2014. Two researchers independently analyzed the data. A key finding was that the factors influencing children’s sedentary behaviors were recognized at all levels of the socioecological model. Parents and personnel acknowledged that children’s age, gender, and personal characteristics had an influence on the incidence of sedentary behaviors. The physical and social environments at home and at preschool seemed to work in a synergetic way. Sedentary behavior was focused on screens at home because of the wide variety of screens available for children to use. On the other hand, the existence and use of screens in preschools were rare. The routines and structures of the daily agenda in preschool define the sedentary behaviors, and how much children sit is dependent on personnel’s motivation. Hurriedness and lack of rules at home increased children’s sedentary behaviors. Overall, the vast majority of the preschool personnel and parents shared an understanding that the children in their care were not sedentary. The findings of this study support the use of the socioecological model in shedding light on the sedentary behaviors of preschool children. Interventions targeted at diminishing preschool children’s sedentary behaviors should focus on different aspects of sedentary behaviors at home and at preschool.
This article discusses the extent it is possible to delay clothing disposal through improved design, thus reducing negative environmental impacts. This has been done by including user centered design methods into more traditional quantitative consumer research to give new insights for design. Empirical data on reasons for disposal of 620 clothing items from 35 persons in 16 Norwegian households was collected. In total, 70 different disposal reasons were registered, which were combined into seven main categories. Changes in garments as well as size and fit issues dominated, while functional, situational, taste, and fashion related reasons were less common. The article concludes with design solutions on four levels related to the important disposal reasons including product design (material and shape), service design, and systems design, but also shows that consumer behaviour is crucial. In addition, the combination of results obtained with various qualitative and quantitative methods proved to be suitable for giving rich data that can be used to drive design research forward.
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