Consumer acceptance of intervention strategies for healthy food choices

The need for more effective interventions to combat the obesity problem has been expressed by many public health experts. While consumer support is important for intervention effectiveness, little is known about why consumers accept or do not accept food choice interventions. The present thesis therefore aims to examine the process underlying acceptance of intervention strategies for healthy food choices. Particularly the role that intervention characteristics (e.g. the source and the location of an intervention) and individual characteristics (i.e. consumers’ perceived barriers for behaviour) play in this process is investigated. Three research questions are formulated: 1) <em>What are the drivers of consumer acceptance of intervention strategies for healthy food choices?;</em> 2) <em>How do consumers’ barriers for healthy food choices influence both food choices in real-life and acceptance of interventions?;</em> 3) <em>How does intervention intrusiveness influence acceptance and effectiveness of intervention strategies for healthy food choices?</em> General beliefs about the obesity problem and intervention-specific beliefs are identified as the main drivers of intervention acceptance in the food domain (<strong>Chapter 2</strong>). General beliefs comprised both people’s ideas about the magnitude of the obesity problem and the responsibility for food choices that consumers make. Intervention-specific beliefs, on the other hand, concerned people’s perceptions of whether an intervention will be effective, both personally and societally, in stimulating healthy food choices (perceived effectiveness) as well as whether the intervention is a fair way of stimulating healthier choices (perceived fairness). Consumers’ motivation-related barriers are associated strongest with real-life food choices, with higher levels of motivation to choose healthy foods being related to higher proportions of healthy choices (<strong>Chapter 3</strong>). Barriers related to the perceived opportunity and ability to choose healthy foods are associated less strongly with real-life choices, with higher levels of opportunity and ability being related to higher proportions of healthy food choices. Three distinct barrier profiles regarding choosing healthy foods are identified: the no-barrier profile (consisting of those who perceive to have no barriers), the lack-of-opportunity profile (consisting of those who perceive to lack opportunity), and the lack-of-motivation profile (consisting of those who report not being motivated). Consumers with a no-barrier profile or a lack-of-opportunity profile perceive interventions to be more effective, more fair, and more acceptable than those with a lack-of-motivation profile (<strong>Chapter 4</strong> and <strong>5</strong>). Acceptance of less intrusive interventions, such as calorie information provision, is higher than those of more intrusive interventions, such as elimination of unhealthy choices, both in hypothetical (<strong>Chapter 4</strong>) and realistic (<strong>Chapter 5</strong>) settings. In the hypothetical setting, the effect of intrusiveness on acceptance is mediated by both the perceived effectiveness and the perceived fairness of interventions: the more consumers perceive an intervention to be effective and fair, the more they accept it (<strong>Chapter 4</strong>). In the realistic setting, the effect of perceived intrusiveness on acceptance is mediated only by the perceived fairness of interventions (<strong>Chapter 5</strong>). In a vending machine setting, the implementation of an intervention that eliminates 50% of unhealthy choices leads to higher proportions of healthy choices than the implementation of less intrusive interventions (providing calorie information through labelling and not intervening at all). Since acceptance does not differ between these interventions (<strong>Chapter 5</strong>), elimination of unhealthy choices appears to be the best way to stimulate consumers to make healthy choices. Overall, this thesis show that consumers’ general- and intervention-specific beliefs drive acceptance of intervention strategies for healthy food choices. Intervention intrusiveness partly influences acceptance, depending on the setting in which consumers are confronted with them (hypothetical vs. realistic). Furthermore, barriers that consumers perceive to have in relation to choosing healthy foods impact acceptance of interventions as well. These insights provide implications for policy makers, both in terms of the development and the communication of intervention strategies for healthy food choices.