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Consumer taste tests and milk preference in low-income, urban supermarkets
Abstract
Objective:
To explore shoppers' responses to the taste of different types of cow's milk in a blind taste test and to examine their willingness to purchase lower-fat milk as part of an in-store marketing intervention.
Design:
Participants were recruited on-site in the supermarket to participate in a blind taste test of three varieties of cow's milk and asked to guess what type they sampled.
Setting:
The taste testing was conducted as part of the Healthy Retail Solution (HRS) intervention that took place in four large supermarkets in Philadelphia, PA, USA over the course of six months.
Subjects:
Adults (n 444) at participating Philadelphia supermarkets.
Results:
The majority of participants at all stores reported typically purchasing higher-fat milk. Forty per cent of participants reported buying whole milk, 38 % purchased milk with 2 % fat. Very few participants correctly identified all three milk samples during the taste test (6·9 %) and a majority of participants were unable to identify the type of milk they self-reported typically purchased.
Conclusions:
Most consumers could not accurately distinguish between various types of milk. Taste testing is a promising strategy to introduce lower-fat milks to consumers who have not tried them before. Campaigns to purchase skimmed, 1 % or 2 % milk may result in significant energy reduction over time and can serve as a simple way to combat overweight and obesity.
... With a focus on the barriers and facilitators, softer dairy product consumption was associated with a higher liking for or a higher appreciation of the taste of dairy products. Liking and taste are strong predictors of food intake in older adults, as discussed above, and effects for dairy products specifically have previously been elucidated [25,26,[57][58][59]. An appreciation for taste may be particularly prominent for this product group, furthermore, given the variety of tastes within the dairy category, from salty, smoked, and blue cheeses to sweet, flavoured yoghurts and desserts, and the variety in taste intensity. ...
... Strategies to increase liking that focus on flavour enhancement or addition may be less suitable for softer dairy products, while strategies that focus more on experiencing and embracing the variety of tastes that naturally exist may be more advisable. Previous work demonstrates the value of tastings for increasing product acceptance [59], and larger food repertoires have been associated with improved health. The increased consumption in our data, furthermore, by those with less reliance on habit, would suggest an openness to differing tastes and flavours in softer dairy consumption. ...
... The associations with perceived ability most likely reflect the ease with which softer dairy products can be consumed, not only due to softer textures but also due to the lack of cooking required, the individual packaging, and the light-weight nature of many of these foods [25,59]. These findings suggest that focusing on increasing the convenience of consuming these foods, again in terms of ease and effort, may be of value. ...
Older adults may gain health benefits from the consumption of animal-based protein-rich foods, but environmental pressures suggest advocating some meat and dairy foods over others, and understanding the barriers and facilitators for consuming these different foods would be of value. Existing data on the barriers to and facilitators of the consumption of meat and dairy products were re-analysed for differing effects for white, red, and processed meat consumption and for yoghurt, soft cheese, and hard cheese consumption. White meat consumption was associated with fewer concerns over spoilage and waste and stronger perceptions that meat is convenient (smallest Beta = 0.135, p = 0.01), while red and processed meat consumption were positively associated with liking /taste, appearance, and convenience (smallest Beta = 0.117, p = 0.03). Yoghurt and soft cheese consumption were positively associated with liking/taste and medical concerns, and fewer concerns over ability and habit (smallest Beta = −0.111, p = 0.05), while hard cheese consumption was only associated with liking/taste (Beta = 0.153, p = 0.01). Taken together, these data suggest that enhancing or promoting the enjoyment, taste, visual appeal, and ease-of-consumption of the more sustainable meat and dairy options may be of value in encouraging the consumption of these foods in older adults.
... Promotion was the most commonly utilized marketing P and was the focus of 23 studies. Overall, 1 study had mixed effects (positive + negative) [16], 5 had mixed effects (positive + null) [17][18][19][20][21], 8 had mixed effects (positive + null + negative) [22][23][24][25][26][27][28][29], 1 had negative effects [30], 2 had null effects [31,32], and 13 had positive effects [33][34][35][36][37][38][39][40][41][42][43][44][45], (see Table 2). ...
... Twenty-three studies used a promotion strategy [17,[19][20][21][22][24][25][26][27][28][30][31][32]34,[36][37][38][39][41][42][43][44][45] as the sole intervention approach. Ten promotion interventions had positive effects [34,[36][37][38][39][41][42][43][44][45], four reported mixed effects (positive + null) [17,[19][20][21], six reported mixed effects (positive + null + negative) [22,[24][25][26][27][28], two reported null effects [31,32], and one reported negative effects [30]. ...
... Twenty-three studies used a promotion strategy [17,[19][20][21][22][24][25][26][27][28][30][31][32]34,[36][37][38][39][41][42][43][44][45] as the sole intervention approach. Ten promotion interventions had positive effects [34,[36][37][38][39][41][42][43][44][45], four reported mixed effects (positive + null) [17,[19][20][21], six reported mixed effects (positive + null + negative) [22,[24][25][26][27][28], two reported null effects [31,32], and one reported negative effects [30]. ...
This review examines current research on manipulations of U.S. food retail environments to promote healthier food purchasing and consumption. Studies reviewed use marketing strategies defined as the 4Ps (product, price, placement, promotion) to examine results based on single-and multi-component interventions by study design, outcome, and which of the "Ps" was targeted. Nine electronic databases were searched for publications from 2010 to 2019, followed by forward and backward searches. Studies were included if the intervention was initiated by a researcher or retailer, conducted in-store, and manipulated the retail environment. Of the unique 596 studies initially identified, 64 studies met inclusion criteria. Findings show that 56 studies had at least one positive effect related to healthier food consumption or purchasing. Thirty studies used single-component interventions, while 34 were multi-component. Promotion was the most commonly utilized marketing strategy, while manipulating promotion, placement, and product was the most common for multi-component interventions. Only 14 of the 64 studies were experimental and included objective outcome data. Future research should emphasize rigorous designs and objective outcomes. Research is also needed to understand individual and additive effects of multi-component interventions on sales outcomes, substitution effects of healthy food purchases, and sustainability of impacts.
... Healthiness or perceived healthiness has also previously been found to be particularly important for older individuals where health may be more fragile and more of a concern [60,71,72]. Others also report the higher consumption of other animal-based protein-rich foods investigated in this study, by those who consider them to be healthy [73][74][75][76][77]. ...
... Effects due to liking/tastiness are again unsurprising, and have previously been demonstrated in association with dairy consumption [74,76,77]. ...
... Some reasons provided for consumption by other researchers were also not found to be important in our sample. Healthiness, for example, has previously been identified as important for fish [82], egg [73] and dairy [74][75][76][77] consumption, as well as for meat consumption. Medical factors have previously been found to be important for dairy consumption [74,76,77]. ...
Protein intakes in the older population can be lower than recommended for good health, and while reasons for low protein intakes can be provided, little work has attempted to investigate these reasons in relation to actual intakes, and so identify those of likely greatest impact when designing interventions. Questionnaires assessing: usual consumption of meat, fish, eggs and dairy products; agreement/disagreement with reasons for the consumption/non-consumption of these foods; and several demographic and lifestyle characteristics; were sent to 1000 UK community-dwelling adults aged 65 years and over. In total, 351 returned questionnaires, representative of the UK older population for gender and age, were suitable for analysis. Different factors were important for consumption of the four food groups, but similarities were also found. These similarities likely reflect issues of particular concern to both the consumption of animal-based protein-rich foods and the consumption of these foods by older adults. Taken together, these findings suggest intakes to be explained by, and thus that strategies for increasing consumption should focus on: increasing liking/tastiness; improving convenience and the effort required for food preparation and consumption; minimizing spoilage and wastage; and improving perceptions of affordability or value for money; freshness; and the healthiness of protein-rich foods.
... Two studies evaluated interventions that were solely composed of food tasting and demonstrations (Table 2) [47,48]. Of these, one study was experimental [47] and one was pre-experimental [48]. ...
... Two studies evaluated interventions that were solely composed of food tasting and demonstrations (Table 2) [47,48]. Of these, one study was experimental [47] and one was pre-experimental [48]. Both studies reported positive effects on healthy food purchasing or consumption. ...
This review identifies the most promising intervention strategies for promoting the purchase and consumption of healthier items within U.S. grocery retail settings, with a particular focus on those strategies that may be most effective when implemented within SNAP-authorized retail settings. Searches of nine electronic databases, as well as forward and backward searches, yielded 1942 studies. After being screened, 73 peer-reviewed academic articles were identified for inclusion. Of these, 33 analyzed single-component interventions, while 40 assessed multi-component interventions. The following unique intervention types were considered as evaluated in these studies for their ability to increase healthy item purchasing and consumption: (1) nutrition scoring, (2) nutritional messaging, (3) non-nutritional messaging, (4) endcaps and secondary placement, (5) point-of-sale interventions, (6) increased stocking, (7) food tasting and demonstrations, (8) nutrition education, and (9) placement on shelf interventions. Nutritional scoring and nutritional messaging emerged as the most rigorously tested and effective intervention strategies. Other strategies warrant more research attention. Simple intervention strategies, as opposed to complex ones, yield the most successful results and minimize shopper burden. Therefore, these strategies should be reviewed for policy implementation within SNAP-authorized grocery retailers.
... While our research did not focus on the rationale for repeat purchasing from the perspective of the buyer, prior research may provide some insight. One study by Weiss et al. (2015) documented substantial differences in perceptions of the taste of full-fat and whole milk as compared to actual preferences during blind taste tests. In this study, consumers were asked to taste blind-samples of skim, 1%, and 2% milk and determine the type of milk. ...
... In this study, consumers were asked to taste blind-samples of skim, 1%, and 2% milk and determine the type of milk. Results showed that 81% of whole milk buyers incorrectly identified low-fat milk as whole milk, and 70% of whole milk drinkers and 65% of 2% milk drinkers considered switching to low-fat milk after tasting the product (Weiss et al., 2015). This may explain the repeat low-fat milk purchasing, reinforcing the notion that once consumers taste low-fat milk, it is found to be an acceptable alternative to whole milk. ...
The purpose of this study was to evaluate a multifaceted, collaborative approach to supermarket environmental change which included in-store couponing and educational marketing to increase low-fat milk purchasing across a 48-store supermarket chain serving predominately Hispanic customers. Point-of-sale (POS) and process data collected during the 16-week program implementation included in-store radio advertising, in-store signage, and POS coupons. POS data were analyzed by the coupon marketing partner, and a chi-square test was conducted to test for significant differences between groups. POS data indicated that 44,050 low-fat milk coupons were issued to traditional full-fat milk purchasing customers with a redemption rate of 5.3%. Of these, 42% became repeat low-fat milk purchasers (i.e., after initial purchase with coupon, customer re-purchased low-fat milk). Results from the chi-square test revealed significant differences in rates of purchase between those who received a coupon (5.87%) and those who did not (4.00%), (χ2 = 8.61, p = .0033). Findings indicate that collaborative public health efforts between retail and marketing partners to engage supermarket customers in a multifaceted yet targeted intervention are feasible, and can shift purchasing behaviors towards a healthy alternative. This study has implications for informing future environmental change supermarket strategies.
... The data from the 3 locations were collected from December 9 to 19, 2019, on December 3, 2019, and on December 21, 2019. The milk samples were served in 50-mL transparent plastic glasses coded by randomly selected 3-digit numbers during the blind tasting (Tuorila, 1987;Colonna et al., 2011;Weiss et al., 2015). ...
Greater differentiation is being made between types of milk according to product and process characteristics. This study investigated consumer preferences for 4 different types of milk in packaging-blind and nonblind experiments. The taste of long-life milk, conventional fresh whole milk, pasture-based milk, and organic milk was assessed by 138 randomly selected respondents. The average taste of packaging-blind versus nonblind milk types was statistically significantly different for each of the 4 milk types. Consumers appeared to be influenced by the milk's packaging and related credence-good attributes. It is noteworthy that the taste of organic milk during the blind tasting was given a lower rating, and the taste of long-life milk or UHT milk a higher rating, than when respondents were aware of the respective milk types. The study estimated multilevel mixed-effects logistic regression models with the response variable buying decision. Of all the factors studied in the blind and nonblind tasting of almost all milk types, buying decisions were influenced most by taste, overall assessment and income.
... Although statistically insignificant, participants who consumed whole, chocolate, or flavored milks believed in previous statements more strongly. Participants may view that these milks as more wholesome as observed in an intervention study conducted by Weiss and colleagues, whose participants indicated whole milk's higher healthfulness by referring to it as "vitamin D" milk [42]. ...
Identifying effective strategies to promote healthy eating and reduce obesity is a priority in the USA, especially among low-income and minority groups, who often have less access to healthy food and higher rates of obesity. Efforts to improve food access have led to more supermarkets in low-income, ethnically diverse neighborhoods. However, this alone may not be enough to reduce food insecurity and improve residents' diet quality and health. This paper summarizes the design, methods, baseline findings, and supermarket in-store marketing strategy compliance for a randomized trial of the impact of healthy food marketing on the purchase of healthier "target" food items. Thirty-three supermarkets in low-income, high-minority neighborhoods in the metropolitan Philadelphia area were matched on store size and percentage of sales from government food assistance programs and randomly assigned to the intervention or control group. Healthy marketing strategies, including increased availability of healthier "target" products, prime shelf-placement and call-out promotion signs, and reduced availability of regular "comparison" products, were implemented in 16 intervention stores for an 18 month period for over 100 individual food items. Six product categories were studied: bread, checkout cooler beverages, cheese, frozen dinners, milk, and salty snacks. The primary outcome measure was weekly sales per store in each product category for 1 year preintervention and 18 months during the intervention. Compliance with the marketing strategies was assessed twice per month for the first 6 months and once a month thereafter. Store and neighborhood characteristics were not significantly different between control and intervention stores. Intercept surveys with customers to assess shopping habits and grocery marketing environment assessments to examine the food promotion environment were completed in the same six food categories. In intercept surveys, 51.0% of shoppers self-identified as overweight and 60.6% wanted to change their weight. Shoppers who typically purchased one type of food over another commonly did so out of habit or because the item was on sale. Findings revealed that preintervention sales of healthier "target" or regular "comparison" items did not differ between intervention and control stores for 1 year prior to intervention implementation. Rates of compliance with the healthy marketing strategies were high, averaging 76.5% over the first 12 months in all 16 stores. If healthy in-store marketing interventions are effective in this scaled-up, longer-term study, they should be translated into wider use in community supermarkets.
The objective of this study was to assess consumers' ability to correctly identify different types of milk in a blind taste test and correlates of plans to purchase lower fat milk. Adults from 8 supermarkets in low-income neighborhoods tasted 3 types of unlabeled lower fat or fat-free milk samples and guessed the type of each sample. Of the 1074 participants, only 7.6% were able to identify all 3 unlabeled samples correctly. Most adults in this study reported consuming higher fat milk and could not correctly identify milk type by taste alone. Blind taste tests may encourage consumers to drink lower fat milk.
National surveillance data identify disparities in low-fat milk consumption by race/ethnicity and income. Some localized studies have shown disparities in access to low-fat milk by community characteristics.
Our aim was to assess the availability and price of low-fat and higher-fat milk in food stores throughout the United States and examine associations with community characteristics.
We conducted a cross-sectional study involving observational data collection in 2010, 2011, and 2012.
The study included 8,959 food stores in 468 communities where nationally representative samples of students attending traditional public middle and high schools resided.
We studied the availability and price of whole, 2%, 1%, and skim milk.
Multivariate logistic regression and ordinary least squares regression analyses were performed. Models included store type, race/ethnicity, median household income, urbanicity, US Census division, and year of data collection.
Less than half of all stores carried 1% and skim milk, and more than three-quarters of stores carried whole and 2% milk. Regression results indicated that the odds of carrying any type of milk were 31% to 67% lower in stores in majority black and 26% to 45% lower in other/mixed race compared with majority white communities. The odds of carrying specifically low-fat milk were 50% to 58% lower in majority Hispanic compared with majority white communities, and 32% to 44% lower in low-income compared with high-income communities. Some significant differences in milk prices by community characteristics were observed in grocery and limited-service stores. On average, low-fat milk options were more expensive in grocery stores in majority black and rural and suburban communities compared with such stores in majority white and urban communities.
This is the first nationwide study to examine the availability and price of low-fat and higher-fat milk in food stores and show disparities in access by community characteristics. Policies and programs can play a role in increasing accessibility of low-fat milk in stores in nonwhite and low-income communities.
Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
This paper builds on recent research that shows that product experience is based on the interaction of a range of sensory cues whose effect is non-conscious (e.g., visual cues affect taste perception) to revisit the classic issue of product taste testing. We propose that as consumers are unaware of the influence of a range of stimuli on their judgments and experience it is difficult for managers to collect valid and reliable consumer insights regarding the manner in which perceptual and sensory cues affect judgments and how they interact with each other. Therefore, we propose that the methodological paradigm of taste testing can and should be used to examine the effect of strategic and tactical marketing mix decisions in domains when consumer decision-making is non-conscious. Based on previous academic research, specific directions for managers to execute the test are provided: How to design and conduct a taste test, what measures to include and why, and how to analyze taste test results. We provide an example of the insight the methodology can provide using three related taste tests. While we use the attribute of taste as a specific example, the methodology and results can be translated into other domains where consumers may not be able to accurately explicate the reasons for their product experience, but that drive marketing decisions, including and beyond changing intrinsic product attributes.
The 1% or Less Campaign is an effective research-tested program for reducing saturated fat intake by encouraging individuals to switch to low-fat milk. All published studies have been conducted in small communities with mostly White populations. The 6-week intervention included a media campaign, public relations, and taste tests. Campaign effectiveness was measured using sales data and cross-sectional telephone surveys. Survey results showed a significant increase in low-fat milk consumption from 30.2% to 40.8% of milk drinkers (p < .001) with a reduced yet sustained increase at 3 months. This translates to approximately 65,000 people switching to low-fat milk during the campaign with a sustained effect of approximately 32,000 people three months postcampaign. Sales data show an increase of low-fat milk sales from 32.7% to 39.9%. Results are similar to smaller community initiatives, indicating the program is effective in promoting population behavior change but may need booster sessions for sustained effects.
The greater presence of supermarkets in low-income, high-minority neighborhoods has the potential to positively affect diet quality among those at greatest risk of obesity. In-store marketing strategies that draw attention to healthier products may be effective, sustainable, and scalable for improving diet quality and health. Few controlled studies of in-store marketing strategies to promote sales of healthier items in low-income, high-minority neighborhoods have been conducted.
The objective of this study was to evaluate the effects of in-store marketing strategies to promote the purchase of specific healthier items in 5 product categories: milk, ready-to-eat cereal, frozen meals, in-aisle beverages, and checkout cooler beverages.
The design was a cluster-randomized controlled trial conducted from 2011 to 2012. Eight urban supermarkets in low-income, high-minority neighborhoods were the unit of randomization, intervention, and analysis. Stores were matched on the percentage of sales from government food-assistance programs and store size and randomly assigned to an intervention or control group. The 4 intervention stores received a 6-mo, in-store marketing intervention that promoted the sales of healthier products through placement, signage, and product availability strategies. The 4 control stores received no intervention and were assessment-only controls. The main outcome measure was weekly sales of the targeted products, which was assessed on the basis of the stores' sales data.
Intervention stores showed significantly greater sales of skim and 1% milk, water (in aisle and at checkout), and 2 of 3 types of frozen meals compared with control store sales during the same time period. No differences were found between the stores in sales of cereal, whole or 2% milk, beverages, or diet beverages.
These data indicate that straightforward placement strategies can significantly enhance the sales of healthier items in several food and beverage categories. Such strategies show promise for significant public health effects in communities with the greatest risk of obesity.
Dairy product consumption is associated with overall diet quality and adequate intake of nutrients, including calcium, phosphorus, potassium, magnesium, zinc, iron, vitamin B12, protein, riboflavin, and vitamins A and D. This article provides evidence that milk and milk products play a critical role in planning eating patterns that conform to the Dietary Guidelines for Americans for nutrient adequacy and may help reduce risk of some chronic diseases.
The present study uses data from the Continuing Survey of Food Intakes by Individuals 1994–1996, 1998 in order to analyse milk consumption by type, specifically high-fat milk vs. low-fat milk. Whereas trend analysis displays an overall increase in low-fat milk consumption over the last few decades in the United States, a number of individuals still consume high-fat milk varieties, and overall dietary intakes have yet to achieve recommended levels. In light of recent research regarding fat intakes, it is important to understand what factors might cause consumers to purchase high-fat options given the number of low-fat options available in the market. Through the use of Logistic regression, key socio-economic and demographic variables are analysed in order to determine their impacts on the probability of consuming low-fat milk vs. high-fat milk. The results indicate that a number of factors do influence probability of low-fat milk consumption as compared with high-fat milk consumption. Most notably, probability of low-fat milk consumption appears to be positively related to age, education level, and income level. African Americans and other minorities had a lower probability of consuming low-fat milk when compared with White people in the sample population. Also, those respondents designated as low income or living in the South were less likely to consume low-fat milk.
A total of 111 subjects took part in a survey in which attitudes, habits, surveyed ratings of liking and of sensory attributes, and consumption frequency of the three types of milk, skimmed, semi-skimmed and whole fat, were studied. The frame of reference for design and analysis was based in part on the Fishbein and Ajzen model of reasoned action. Habit was found to be more important than attitude in the prediction of the behavioural intention. Liking was more important than intention for predicting behaviour with the exception of semi-skimmed milk for which the intention was equally important, whereas the inclusion of surveyed ratings of sensory/hedonic components for milk into the model failed to improve the prediction of attitude. The relationships between beliefs, evaluations and attitudes were examined.
Total beverage intake patterns have changed greatly over the past half century. The present research was conducted to evaluate historic and current patterns of beverage consumption of adults and children in the U.S. Data were drawn from food balance surveys along with two-day beverage intake averages and were weighted to be nationally representative. A marked slow continuous shift downward in total milk intake with a shift toward an increased proportion of reduced fat milk was determined. The biggest shifts in beverage consumption among children aged 2 to18 were an increase in sugar-sweetened beverages (SSBs) (from 87 to 154kcal/d), a smaller increase in juices (+21kcal/d), and a decrease in milk consumption (-91kcal/d). Data among adults aged 19 and older indicated that SSB intake has more than doubled. Water intake was highly variable, with a marked increase in bottled water intake but no clear trend in total water intake. Overall trends by age were presented and indicated that age-related beverage intake, both in ounces and kcal/day, decreased sharply for adults aged 60 and older. Kcal/d values ranged from a low of 283 for those over age 60 to a peak of 533 for those aged 19 to39 to 367 for 2 to 6year olds. The consumer shift toward increased levels of SSBs and alcohol, limited amounts of reduced fat milk along with a continued consumption of whole milk, and increased juice intake represent issues to address from a public health perspective.
The authors proposed the Lowfat Milk Campaign, a multifaceted social marketing campaign to promote the use of low-fat milk in the Washington Heights-Inwood neighborhood of New York City, a low-income, inner-city, Latino community. The campaign was designed for implementation by the Washington Heights-Inwood Health Heart Program, a community-based cardiovascular disease prevention agency. The first phase of the campaign began in November 1990. A followup phase for the period 1991-92 is in progress. The campaign focuses on a clear, relatively easily accomplished behavioral change, a switch by consumers of whole milk to low-fat milk, which may significantly reduce the fat consumption of persons in such a population, particularly children. The campaign strategy featured a mix of traditional health education methods, intensive local information media publicity, and innovative marketing techniques. In addition to increasing consumer demand for low-fat milk, the campaign successfully promoted institutional changes that are expected to facilitate healthy dietary choices in the future by members of the study population. Schools and other institutions that serve milk have been persuaded to begin offering low-fat milk in addition to, or instead of, whole milk. An essential component of campaign strategy was building support from key community organizations and leaders. Significant assistance was provided by the local school district, parents associations, churches, newspapers, radio stations, fraternal organizations, and a coalition of child care agencies. The campaign demonstrates a cost effective and culturally sensitive approach to promoting important cardiovascular health behavior changes by an underserved population.
The authors evaluated the effectiveness of a community education campaign to encourage a switch from high-fat (whole and 2%) milk to low-fat (1%, 1/2%, and skim) milk as a way to reduce consumption of saturated fat.
Milk sales data were collected from supermarkets in the intervention and comparison communities for three one-month time periods: at baseline, immediately following the campaign, and six months after the campaign. In addition, trained volunteers conducted pre- and post-intervention telephone surveys.
Overall milk sales increased by 16% in the intervention cities following the campaign and remained high at follow-up. Low-fat milk's market share increased from 18% of overall milk sales at baseline to 41% of overall milk sales in the month following the end of the campaign, an increase in market share that was sustained at the six-month follow-up. In the post-intervention telephone survey, 38.2% of those respondents who reported drinking high-fat milk at baseline reported having switched to low-fat milk.
A focused message communicated through paid advertising, public relations activities, and community-based education programs increased low-fat and overall milk consumption in one community.