Michigan Ross School of Business
Yaffe Center for Persuasive Communication

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Leveraging Consumer Psychology for Effective Health Communications: The Obesity Challenge,Book released from 2009 Yaffe Center Conference
Edited by: Rajeev Batra; Punam Anand Keller; Victor J. Strecher

More About the Book:

(FROM THE INTRODUCTION BY YAFFE CENTER CO-DIRECTOR, AND BOOK CO-EDITOR, RAJEEV BATRA)

        The book begins with two stage-setting review chapters, one each from the consumer psychology and public health research arenas. Punam A. Keller and Don Lehmann report their findings from a meta-analysis of 84 relevant consumer psychology papers (involving 584 different experimental observations), investigating how 22 message, individual, and context factors interact in shaping health attitudes and behavioral intentions. They find that factors that improve health attitudes may not increase behavioral intentions and vice versa. For instance, stories about individuals seem to be very effective in shaping attitudes, while the perceived severity of communicated consequences seems important in shaping intentions. In reconciling their results, the authors suggest more research attention on “self-communication,” such as the role of emotions and fantasy in determining various eating behaviors, topics covered in some of our other chapters (e.g., the ones by Mukhopadhyay, and Becheur and Valette-Florence). Keller and Lehmann also highlight the importance of context and individual differences in determining health behaviors. The second review chapter, by the American Heart Association Council on Epidemiology and Prevention, addresses this issue by laying out the enormous range of societal and individual factors that influence the prevalence of obesity. This review allowed us to map out the multiple points and levels at which interventions can be aimed, especially the urgent need for “population-based” efforts to combat the obesity epidemic. We are grateful to the American Heart Association for allowing us to reprint this chapter; it originally appeared in their Circulation journal in 2008.

          In the second section of the book, five chapters examine different “individual-level” or “micro” consumer factors that play a role in consumer belief-formation about how much, what, and when to eat: phenomena such as estimating how many calories a food has, or what determines our perceptions of how much self-control or self-confidence we have about food intake. Anirban Mukhopadhyay reports on research that he and others have conducted that examines the nature and malleability of consumers’ “lay theories” about how much self-control they have over what they eat, how they will feel when they eat, how foods will taste if it is labeled healthy or unhealthy, and so on. He recommends that food-related messages remind consumers that their control over how they eat is quite limited—but can be increased. Alexander Chernev and Pierre Chandon next report on their many clever studies showing that consumers do not accurately estimate the calorie content of the foods they eat: they often think a food is healthy just because one ingredient of it is flagged on a nutrition label as being so (a “halo” bias), and they often underestimate the total calorie content of a pair of foods when one is factually healthy (such as a salad) but the paired item (a hamburger) is not, simply because the pair contains one lower-calorie component (an “averaging” bias). Chernev and Chandon’s findings may be used for regulatory guidelines or warnings for advertisers of unhealthy foods. This chapter is followed by Kelly Geyskens and coauthors describing the counterintuitive result that consumers may actually be better off if they expose themselves to strongly tempting food cues, rather than keeping away from such cues, simply because repeated exposure to unhealthy foods may make them more successful in activating the needed self-control and resistance. Informing consumers that practicing their resistance to unhealthy foods can be beneficial is a unique approach to reducing obesity. Next, Ian Skurnik, Carolyn Yoon, and Norbert Schwarz expand on the role of familiarity by investigating the effect of speed of decision-making as it relates to food choices. The inputs for speedy food choices include the degree of risk consumers face of gaining weight and their perceived ability to successfully carry out weight reduction behaviors. These findings question our basic assumptions about how much thought and planning goes into food choices. Finally, Brent McFerran, Darren Dahl, Gavan Fitzsimons and Andrea Morales show in a very clever manner how even the body type of the restaurant server at our table or nearby diners whose food choices we observe can affect what and how much we eat. Together, the chapters in this section offer significant insight into why consumers behave in a counterproductive manner despite being aware of healthier eating options.

          From these chapters on individual perceptions and misperceptions, the book moves on to examine different communication tactics that can be used to change health attitudes and behaviors. In contrast to the prevalence of loss-frames in health communications, Daniel O’Keefe and Jakob Jensen’s meta-analysis indicates that gain-framed appeals have a persuasive advantage in promoting physical activity—but not when the message concerns healthy eating. They recommend taglines such as “exercise if you want to be the right weight” instead of “if you do not exercise, you will not lose weight.” Jeff Stone next leverages his expertise on hypocrisy to suggest that making consumers aware that they themselves do not practice behaviors that they preach to others—their hypocrisy—can induce cognitive dissonance and raise their motivation to act in obesity-reducing ways. The key is to encourage consumers to publicly advocate obesity-reducing actions. This is followed by a chapter by Imène Becheur and Pierre Valette-Florence in which they study whether negative emotions such as fear, guilt, and shame, which have been successful in reducing alcohol abuse, may be used to combat obesity. They conclude the answer is yes, especially for obesity communications targeting females. Taking a novel perspective on social reference group inferential processes, Lindsay Rand and Jonah Berger show that consumers will actually be more likely to stop following obesity-promoting behaviors—such as junk food consumption—if those behaviors are linked to dissociative reference groups. They show that particular foods are chosen, or not, not only because of their functional qualities, but also because of the social identity they communicate. Finally, using a set of results in the prescription drug compliance domain, Gary Kreps and his colleagues remind us of the importance of listening to consumers for barriers that need to be addressed in tailored obesity messages. The chapters in this section provide important directions for obesity health message content.

           While all the chapters up to this point look at phenomena that can be applied to multiple demographic groups, the next three chapters focus on two population groups of special interest and importance, children and young adults. John Sailors points out that, since breastfed babies tend to be less susceptible to obesity as children and adolescents, messages aimed at mothers to encourage breastfeeding can be very important and need to take into account the women’s individual characteristics—such as their level of self-monitoring—so that the message content is most relevant and persuasive. Nancy Wong and Myoung Kim then take us back to the broader set of contextual and environmental variables (some of which the AHA lists in Chapter 2) to test which environmental and community factors, parental styles, and child characteristics seem to be related to children’s eating and exercise patterns and body mass index. Their structural equations model of national panel data finds that family and media factors are especially important. Concluding this section, Annie Jin describes how avatar-based health games (“exergames”) can be used to prime various aspects of teenagers’ physical self in order to shape their exercise and healthy eating intentions. This chapter set describes the challenges and related solutions to addressing obesity from birth to adolescence.

            The final set of five chapters looks at the crucial role of broader societal and environmental factors that interact with the individual and group-level ones that form the primary focus of most of the earlier chapters. Michael Rothschild, one of the best-known experts on the rationale and use of “social marketing” techniques, shows why and how social marketing principles can be used to increase the effectiveness of public health obesity interventions. The intersection of public service messages with other elements of the marketing mix, such as distribution, is highlighted in his case example on efforts to reduce drunk driving in Wisconsin. This is followed by two chapters on nutrition labeling on food packages. Brian Wansink lays out the objectives and processes used to develop and promote the new food guide pyramid, “MyPyramid,” developed by the USDA, an initiative in which he himself played a major role. Critiquing the design of such communication devices, Jason Riis and Rebecca Ratner argue that such guidelines and depictions should be made even simpler, to increase consumers’ motivation and ability to follow them, and should present an alternative. The last two chapters address the role of marketing, media, and government in exacerbating or controlling obesity. Peter Ubel discusses some of the tensions and trade-offs between libertarianism and paternalism inherent in governmental efforts to more actively fight obesity, arriving at what he considers are the legitimate arenas in which governments should indeed intervene through policy actions. Barbara Loken, K. Viswanath, and Melanie Wakefield draw lessons for obesity-fighting interventions by borrowing specific guidelines from the fight against tobacco use. Among them: the important role played by explicit and implicit messages in the entertainment and news media in shaping consumer perceptions and attitudes, and thus the need to study and possibly regulate their effects.

            Taken together, the chapters in this volume bring to researchers and policy-makers scores of interesting and important ideas on ways to craft obesity-fighting messages and interventions more effectively. The conclusions deserve serious consideration because they derive their strength from a variety of disciplinary paradigms, and they are all based on the highest standards of current research. It is our hope that by assembling and presenting them here we have assisted in the efforts underway to combat this major public health crisis.


 

 Table of Contents and Reviews

Selected Contents:

Foreword Brian Wansink
Introduction Rajeev Batra, Punam A. Keller, and Victor J. Strecher

Part I. Overviews

1. Design of Effective Obesity Communications: Insights from Consumer Research Punam A. Keller and Donald R. Lehmann
2. Population-Based Prevention of Obesity American Heart Association

Part II. Research on Consumer Biases

3. An Ounce of Prevention, An Apple a Day: Effects of Consumers' Lay Theories on Health-Related Behaviors Anirban Mukhopadhyay
4. Calorie Estimation Biases in Consumer Choice Alexander Chernev and Pierre Chandon
5. Food Temptations versus Self-Control: Friends or Enemies? Kelly Geyskens
6. Thinking About Health and Obesity: How Consumers' Mental Experiences Influence Health Judgments Ian Skurnik, Carolyn Yoon, and Norbert Schwarz
7. How the Body Type of Others Impacts Our Food Consumption Brent McFerran, Darren W. Dahl, Gavan J. Fitzsimons, and Andrea C. Morales

Part III. Communication Strategy and Tactics

8. The Relative Effectiveness of Gain-Framed and Loss-Framed Persuasive Appeals Concerning Obesity-Related Behaviors Daniel J. O'Keefe and Jakob D. Jensen
9. Practicing what you Preach: Using Hypocrisy and Cognitive Dissonance to Reduce the Risk for Obesity Jeff Stone
10. The Use of Negative Emotions in Health Communication: Implications for Fighting Obesity Imne Becheur and Pierre Valette-Florence
11. Using Identity Signaling to Combat Obesity and Improve Public Health Lindsay P. Rand and Jonah Berger
12. Developing and Validating Motivational Message Interventions for Improving Prescription Drug Adherence with Consumers Confronting Chronic Diseases Gary L. Kreps, Melinda M. Villagran, Xiaoquan Zhao, Colleen McHorney, Christian Ledford, Melinda Weathers, and Brian Keefe

Part IV. Combating Obesity in Children and Young Adults

13. Preventing Childhood Obesity by Persuading Mothers to Breastfeed: Matching Appeal Type to Personality John J. Sailors
14. Ecological Factors and Childhood Obesity: A Structural Look Nancy Wong and Myoung Kim
15. The Impact of Health Games on Consumers' Physical Activity and Healthy Eating Intentions Seung-A Annie Jin

Part V. Environmental and Policy Perspectives

16. Bringing a Bit of Social Marketing to the Problem of Obesity Michael L. Rothschild
17. Marketing MyPyramid: Taking the Dietary Guidelines Home Brian Wansink
18. Simplified Nutrition Guidelines to Fight Obesity Jason Riis and Rebecca Ratner
19. Shrinking Liberty to Combat Expanding Waistlines Peter A. Ubel
20. Controlling Obesity: Lessons Learned from Tobacco Control and Tobacco Marketing Research Barbara Loken, K. Viswanath, and Melanie A. Wakefield

About the Editors and Contributors
Name Index
Subject Index

Comment(s): "This book is a very important addition to the literature. By relating the many facets of consumer psychology to the obesity problem, it enhances our understanding of the issues and offers a menu of interesting, fresh ideas for combating the challenges. The editors should be commended for assembling such a lineup of leading researchers from multiple disciplines, representing varied perspectives." -- Dogan Eroglu, PhD., Associate Director for Communication Science, Office of the Associate Director for Communication Centers for Disease Control and Prevention

"How great that in one book, these authors have provided the missing audience-centered approaches to addressing one of the major epidemics in our society--obesity. They share rigorous research studies that isolate strategies that work, don't work, and why. They share insights into target audience mindsets and convince the reader (perhaps finally) that interventions must be tailored to the uniqueness of a target audience. And, they share solutions that go beyond communications, ones that involve a strategic integration of Promotions with the other major tools in the social marketer's toolbox: Product, Price, and Place." -- Nancy R. Lee, President, Social Marketing Services, Inc. and coauthor with Philip Kotler of seven books on Social Marketing

"As the public health community moves to treat food the way they treated tobacco, this book offers a refreshing and practical alternative to banning, taxing and blaming. Full of insights from behavioral science and social marketing, it demonstrates multiple ways we can help people develop a healthy lifestyle without treating them like children or victims." -- Bill Smith, Editor, Social Marketing Quarterly

"Any consumer centric focused company knows that people don't always do what they want to do. Like other innovative companies, we also know about the need to deliver compelling and targeted messages. This book provides action oriented and feasible solutions with a focus on obesity. The authors provide insights and research findings that are particularly valuable at this time, given the significant and meaningful changes facing all of us in the healthcare world." -- Bari A. Harlam, Senior Vice President, Marketing CVS Caremark

"This book brings together some of the best academics from consumer psychology and related fields to address obesity, a problem of enormous social importance. The result is a unique and insightful analysis that leverages perspectives, such as those regarding consumer decision making and social marketing that are all-too-often left out of policy discussions. This volume should be useful to academics who care about individual behavior or policy as well as to readers who simply want a fresh vantage point on one of the most basic human concerns, the role of food consumption in health outcomes." -- Mary Frances Luce, Professor of Business Administration and Associate Dean for Faculty Affairs, Fuqua School of Business, Duke University and Faculty, Health Sector Management

" Leveraging Consumer Psychology for Effective Health Communications takes a much needed look at obesity--importantly, why we make poor eating choices when we know they are not in our best interest. The chapters in this book brilliantly confront the decision-making biases we face, focusing on the power of social marketing to create innovative, realistic solutions to improve public health." -- Jordan Goldberg, Co-founder and CEO, stickK.com

 


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Recent Research Publications

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The focus of our research today is the impact of the Internet, lessons about communication principles from popular media and religion and non-linear communication processing styles.

 > Submit your working papers

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> Order the Visual Marketing: From Attention to Action book


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> Order the Persuasive Imagery: A Consumer Response Perspective book


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> Read The Marcom Budgets Report


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