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# The Persuasiveness of Child-Targeted Endorsement Strategies: A Systematic Review

Authors:
• KU Leuven Institute for Media Studies

## Abstract

Several European and U.S. reviews have established the link between food marketing and childhood obesity (EU Pledge, 2012; FTC, 2006; Persson, Soroko, Musicus & Lobstein, 2012), which has stimulated researchers to investigate the effects of the most prevalent child-targeted marketing technique: the use of endorsing characters. This systematic review of these studies (15 identified; participants age 3-12 years) focuses on three important questions: (a) Does a basic endorser effect exist?, (b) Is the strength of the endorsement effect influenced by endorser type?, and (c) Does the endorsement strength differ according to the type of food being promoted?
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... Many studies provided evidence that unhealthy eating behavior is, in part, shaped by an abundance of presentations of unhealthy food in entertainment media (e.g., Auty & Lewis, 2004; (Folkvord, Anschütz, Nederkoorn, Westerik, & Buijzen, 2014); . Not only are children shown more unhealthy foods than heathy food options in media content directed at them, the specific presentations of unhealthy foods are more persuasive than presentations of healthy foods (Smits et al., 2015). ...
... Most studies testing the effectiveness of social endorsers only examined one type of endorser (animals, De Droog et al., 2014;(Neeley & Schumann, 2004)). When it comes to children as consumers, the three types of social endorsers proposed by Friedman and Friedman (1979) have never been experimentally tested for their persuasive potential in nutritional messages, although we know from content analyses that these types of endorsers regularly appear in media content targeted at children (for instance, see content analysis on the presentation of peers; Boyland et al., 2011;Smits et al., 2015). Most studies investigating the effects of social endorsers have not investigated children's choice between unhealthy or healthy foods (for an overview, see Cruwys et al., 2015). ...
... Third, we only used unfamiliar characters in this study, to avoid prior liking effects; hence, our results are not applicable to familiar characters in narrative content. Smits et al. (2015) demonstrated that familiar characters are very persuasive, and future research should replicate this study using familiar experts, celebrities, and peers. In our study, the ineffectiveness of celebrities as social endorsers in particular might be due to the fact that celebrities' effectiveness is because they are typically famous and well-liked by the audience (Boyland et al., 2011). ...
Article
This study investigates whether the source providing nutritional information matters for children's choice of fruit over candy. We conducted a between-subject experimental study with children (6–11 years; Mage = 8.20; N = 340). Children watched an audiovisual cartoon with nutritional messages provided by experts (expert condition), by celebrities (celebrity condition), or by typical consumers (peer condition). Additionally, we included a control group in which children were not exposed to any cartoon. As the dependent variable, we measured children's fruit choice over candy. As a mediator, measuring message processing, we included children's argument awareness. Moreover, children's age was included as a moderator. The results indicate that the experimental conditions were equally effective in creating argument awareness for healthy eating compared to the control group. Children's argument awareness was generally rather low, and it did not influence children's fruit choice over candy. Nevertheless, there was a direct effect of the expert condition on children's fruit choice, pointing to an internalized “expert heuristic”. No moderating effects of children's age were present. Our study indicates that using experts to present nutritional information within narrative media content is a potentially successful strategy to create argument awareness for healthy food and to impact children's selection of healthy food.
... Persuasive marketing strategies influence children's and adolescents' food intake, preferences, attitudes, and eating behavior (18)(19)(20). They are particularly harmful at this stage of life because their cognitive development is relatively limited, making it harder for them to recognize the persuasive intent of marketing used by the food industry (21,22). Food marketing may also affect children's purchasing preferences for foods and influence long-term norms related to food consumption (23,24). ...
... Food marketing may also affect children's purchasing preferences for foods and influence long-term norms related to food consumption (23,24). Despite that marketing on food packaging is less studied than televised food marketing in addressing childhood obesity (19,25), current evidence suggests that cartoon characters and other endorsers including brand mascots, celebrities, sports figures comprise the most prevalent type of marketing targeted at children on food packages (19,22). As the sales of packaged foods in LA rise, particularly that of ultra-processed foods (26), this evidence gap may constrain effective policymaking to prevent childhood overweight and obesity. ...
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Objectives This study aimed to examine and compare the extent to which different nutrient profile models (NPMs) from Latin America (LA) identify packaged foods and beverages with child-directed marketing sold in Brazil as being high in nutrients associated to the risk of non-communicable diseases (NCDs). Materials and methods In this cross-sectional study, we evaluated 3,464 foods found in the five largest Brazilian supermarkets. Child-directed marketing was coded using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) protocol. Differences in medians of sugar, saturated fats, and sodium per 100 kcal in foods, with the presence and absence of child-directed marketing, were tested using the Mann–Whitney test. We compared six NPMs in LA and examined to what extent they targeted these products using prevalence ratios. Analyses were performed overall and by the degree of food processing according to the Nova food classification. Results We found 1,054 packages with child-directed marketing. Among these, candies, cakes and pies, sauces and creams, and sugar-sweetened beverages were significantly higher in sugar, saturated fat, and sodium per 100 kcal than products that are not targeted at children ( p < 0.05). Compared with PAHO and the Mexico models, the Brazilian NPMs would allow three times more ultra-processed foods to omit warnings for sodium ( p < 0.05). The Uruguayan NPM also flagged fewer ultra-processed foods high in sodium ( p < 0.05). The Brazilian model also allows four times more sugar-sweetened beverages and six times more dairy drinks to omit warnings for sugar than the Mexico and PAHO models. In comparison to all other NPMs, the Brazilian model showed the worst performance in identifying baked goods as high in sodium. Chile, Uruguay, and Peru models would also target significantly less sugar-sweetened beverages and high in at least one critical nutrient than PAHO and Mexico models. Conclusion Compared with other NPMs in LA, the NPM criteria adopted in Brazil are more permissive and less likely to inform consumers of the poor nutritional quality of ultra-processed foods and beverages with child-directed marketing.
... Children's exposure to unhealthy food and beverage marketing has a direct impact on their dietary preference for, and consumption/intake of, these products (1)(2)(3)(4)(5) . In addition, children are particularly vulnerable to the persuasive power of marketing messages and techniques (for example, celebrity and athlete endorsements, in-store marketing and toy co-branding) (1,(5)(6)(7) . ...
... Children's exposure to unhealthy food and beverage marketing has a direct impact on their dietary preference for, and consumption/intake of, these products (1)(2)(3)(4)(5) . In addition, children are particularly vulnerable to the persuasive power of marketing messages and techniques (for example, celebrity and athlete endorsements, in-store marketing and toy co-branding) (1,(5)(6)(7) . As the burden of child malnutrition in all its forms continues to rise globally (8) , the improvement of food environments through restricting children's exposure to, and the persuasive power of, marketing practices stands out as a priority in public health nutrition policy. ...
Article
Objective To determine the implications of international trade and investment agreements (TIAs) for national governments’ policy space to restrict the marketing of unhealthy food and beverages to children. Design In-depth interviews based on a series of policy scenario ‘vignettes,’ guided by an adapted scenario analysis methodology. Setting Global Participants Nine key informants from relevant sectors, with expertise regarding the intersection of public health nutrition policy, international trade law, and international investment law. Results Participants consistently identified the relevance of several principles, common to many TIAs: non-discrimination, necessity and justification, market access requirements and quantitative restrictions, intellectual property rights and trademark protections, and fair and equitable treatment of investors. Two main policy design factors that interact heavily with TIA-related policy space were the framing of objectives, and regulatory distinctions drawn. Contextual factors may shape the analysis of TIA-related policy space on a case-by-case basis, while the relative power of the actors and institutions involved in both domestic and international policy spheres may influence whether and how such legal constraints to policy space are activated. Conclusions Regulatory marketing restrictions run the risk of incurring challenges under World Trade Organization (WTO) agreements and other free trade and investment agreements. However, concerned policy makers should be aware of the difference between theoretical risk, threat of a challenge, and realistic initiation and/or loss of a formal dispute. Our findings indicate that there is policy space to adopt significant marketing restrictions, though an understanding of these legal risks, and strategic policy design, are important.
... However, empirical findings indicate that short-term exposure to the influencer marketing of healthy foods does not encourage children to consume or choose these foods [15,92]. Similarly, some literature has demonstrated smaller-sized effects (or no effect) of celebrity endorsement of healthy foods, relative to unhealthy foods, on children's appetitive response [93]. Thus, the promotion of fruits and vegetables is considered to not be as straightforward as the promotion of candy, fast food, or soft drinks, and that more persuasive tactics and repeated exposure may be needed [94]. ...
Article
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Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere. This could contribute to the obesity epidemic that we are facing. As the majority of children and adolescents do not eat the recommended amount of fruits and vegetables (F&V), which leads to chronic diseases, we need to change the obesogenic environment to a healthogenic environment. Reducing the marketing of energy-dense snacks to children and increasing the promotion of healthier foods, such as fruits and vegetables, may be an effective and necessary instrument to improve the dietary intake of children and reduce the risk of their experiencing some chronic diseases later in life. With this focused narrative review, we provide an overview of how children and adolescents react to food promotions and how food promotional efforts might be a useful tool to increase the attractiveness of fruit and vegetables. This review therefore contributes to the question of how changing the advertising and media environment of children and adolescents could help create a world where the healthy choice is the easier choice, which would reduce childhood obesity and improve children’s health, as well as to make the food system more sustainable.
... Influencers have been recently defined as "individuals on social media who have built a credible reputation and following, oftentimes in a specific topic area" [11]. Their online contributions, opinions and posts can affect their fanbase, thus conditioning public behaviors [12][13][14][15]. For such reasons, public health organizations are increasingly encouraging scientists' active participation in social media communication [9,10]. ...
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... As for its effect on food promotions, a comparison of food advertising viewed by children in Quebec and Ontario found that food advertisements broadcast during the preferred television programming of Francophone children in Quebec were slightly healthier compared with those airing on the preferred programming of their Anglophone counterparts in Quebec and Ontario (23) . Francophone children in Quebec were also less likely to be exposed to endorsement characters or celebrities, which is a particularly persuasive marketing technique among children (24,26) . ...
Article
... There is a growing concern among public health officials regarding the number of advertisements for risky products e.g., alcohol, gambling, unhealthy food and beverages 16,17 . Numerous studies conducted around the world indicate that exposure to unhealthy energy-dense, nutrition-poor food and beverage advertisements can promote unhealthy eating habits [18][19][20][21][22][23][24] . The marketing of products that are high in fat, sugar and salt to children is particularly concerning, as it increases the potential for diet-related diseases later in life 21 . ...
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While outdoor advertisements are common features within towns and cities, they may reinforce social inequalities in health. Vulnerable populations in deprived areas may have greater exposure to fast food, gambling and alcohol advertisements, which may encourage their consumption. Understanding who is exposed and evaluating potential policy restrictions requires a substantial manual data collection effort. To address this problem we develop a deep learning workflow to automatically extract and classify unhealthy advertisements from street-level images. We introduce the Liverpool 360∘\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${360}^{\circ }$$\end{document} Street View (LIV360SV) dataset for evaluating our workflow. The dataset contains 25,349, 360 degree, street-level images collected via cycling with a GoPro Fusion camera, recorded Jan 14th–18th 2020. 10,106 advertisements were identified and classified as food (1335), alcohol (217), gambling (149) and other (8405). We find evidence of social inequalities with a larger proportion of food advertisements located within deprived areas and those frequented by students. Our project presents a novel implementation for the incidental classification of street view images for identifying unhealthy advertisements, providing a means through which to identify areas that can benefit from tougher advertisement restriction policies for tackling social inequalities.
... In addition to sponsorship, two companies, namely Danone and McDonalds, were also identified as using professional athletes as ambassadors for their initiatives. These types of endorsement strategies are particularly persuasive among children [36]. Unsurprisingly, the use of celebrity athletes has also been shown to have a "health halo" effect whereby influencing the perceived healthfulness of food products, even among adults [37]. ...
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Background: As diet-related diseases have increased over the past decades, large food companies have come under scrutiny for contributing to this public health crisis. In response, the food industry has implemented Corporate Social Responsibility (CSR) initiatives related to nutrition and physical activity to emphasize their concern for consumers. This study sought to describe the nature and targeted demographic of physical activity and nutrition-related CSR initiatives of large food companies in Canada and to compare companies who participate in the Canadian Children's Food and Beverage Advertising Initiative (CAI), a self-regulatory initiative aimed at reducing unhealthy food advertising to children, with non-participating companies. Methods: A cross-sectional study was conducted in 2016. Thirty-nine large food companies, including 18 participating in the CAI, were included in the study. The webpages, Facebook pages and corporate reports of these companies were surveyed to identify CSR initiatives related to nutrition and physical activity. Initiatives were then classified by type (as either philanthropic, education-oriented, research-oriented or other) and by targeted demographic (i.e. targeted at children under 18 years or the general population). Differences between CAI and non-CAI companies were tested using chi-square and Mann-Whitney U tests. Results: Overall, 63 CSR initiatives were identified; 39 were nutrition-related while 24 were physical activity-related. Most (70%) initiatives were considered philanthropic activities, followed by education-oriented (20%), research-oriented (8%) and other (2%). Almost half (47%; n = 29) of initiatives targeted children. Examples of child-targeted initiatives included support of school milk programs (n = 2), the sponsorship of children's sports programs (n = 2) and the development of educational resources for teachers (n = 1). There were no statistically significant differences in the number of CSR initiatives per company (CAI: Mdn = 1, IQR = 3; non-CAI: Mdn = 0, IQR = 2; p = .183) or the proportion of child-targeted initiatives (CAI: 42%; non-CAI: 54%; p = .343) between CAI and non-CAI companies. Conclusion: Food companies, including many that largely sell and market unhealthy products, are heavily involved in physical activity and nutrition-related initiatives in Canada, many of which are targeted to children. Government policies aimed at protecting children from unhealthy food marketing should consider including CSR initiatives that expose children to food company branding.
... Children prefer products that feature a licensed endorser, but this cue cannot convince them to prefer a core over a non-core food product. This result corresponds with findings from the review by Smits et al. [22] that endorsers influence children's behaviors, but that this influence is probably smaller for core food products. Illustrations could present a more promising tool to nudge children towards healthier eating behaviors. ...
Article
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Packaging is increasingly recognized as an essential component of any marketing strategy. Visual and informational front-of-pack cues constitute salient elements of the environment that may influence what and how much someone eats. Considering their overwhelming presence on packaging of non-core foods, front-of-pack cues may contribute to the growing rates of overweight and obesity in children and adults. We conducted a systematic review to summarize the evidence concerning the impact of front-of-pack cues on choices and eating behaviors. Four electronic databases were searched for experimental studies (2009–present). This resulted in the inclusion of 57 studies (in 43 articles). We identified studies on children (3–12 years) and adults (≥ 18 years), but no studies on adolescents (12–18 years). The results suggest that children and adults are susceptible to packaging cues, with most evidence supporting the impact of visual cues. More specifically, children more often choose products with a licensed endorser and eat more from packages portraying the product with an exaggerated portion size. Adults’ eating behaviors are influenced by a range of other visual cues, mainly, package size and shape, and less so by informational cues such as labels.
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