#PHTwitJC 22 Transcript: Impact of advertising restrictions on children’s exposure to adverts for less healthy foods

  1. This is the Storify transcript & summary of our discussion on 26th February.

    Information about the Public Health Twitter Journal Club, including our introduction to this discussion, can be found at our blog: https://phtwitjc.wordpress.com
  2. On 26th Feb 2013, we were discussing this research paper:
  3. Q1: were the aims of the study clearly defined?
  4. @PHTwitJC yes, very clear, assess the impact of the regulation, within the limits of the study design #phtwitjc
  5. @PHTwitJC I agree but thought they could have been more detailed #PHTwitJC
  6. @PHTwitJC not explicitly clear, e.g. “explored the impact of the restrictions on relative exposure” #PHTwitJC
  7. @rorymorr @carotomes I felt clear what they wanted to do, but can see the ‘statement’ of aims Caro cites is maybe a bit vague. #PHTwitJC
  8. Q2: Was the study design appropriate to answer this research question, and adequately described? #PHTwitJC
  9. Q2- Study design question led to some discussion about the timing of the study weeks (comparability); and the methodology used to calculate viewing exposure:
  10. @PHTwitJC cross-sectional ecological design is appropraite for population intervention #PHTwitJC
  11. @PHTwitJC described well… adequate is more problematic imo, not very good info on background ad trends (esp seasonal ones) #phtwitjc
  12. @rorymorr @PHTwitJC agree with seasonal trends, study conducted at same point in time though #PHTwitJC
  13. @Claire_McLeod @PHTwitJC was it though? Oct 2006 but then Jul 2009… summertime ads compared to autumn, big push for ice lollies? #phtwitjc
  14. @Claire_McLeod @PHTwitJC yeah, I guess cld go either way – point is you don’t get good idea of potential seasonality. #PHTwitJC
  15. I wondered whether a week was a long enough period to reflect avg exposure… (maybe study budget restricted data) #PHTwitJC
  16. One of the authors later responded to the queries about the selected time periods:

  17. @carotomes Oct & July were 6m before/after implementation of the intervention as far as I remember. There was a clear rationale, honest!
  18. Discussion of the study design continued:
  19. @PHTwitJC they described it in detail to replicate. using such a large range of adverts/minutes could have lost quality in data #PHTwitJC
  20. @PHTwitJC TVR data and methodology was novel to me; film studies bf assures me this is flawed but good method for rep sample #PHTwitJC
  21. Use of TVRs in research new to me too but most established way of working out viewing figs, it seems #PHTwitJC
  22. With the TV panel thing, can’t be 100% accurate *but* advertisers & TV cos use them to determine scheduling, so v valid for this #PHTwitJC
  23. @rorymorr @PHTwitJC yes, surely has same issues with compliance as food diaries etc #PHTwitJC
  24. @PHTwitJC @rorymorr got to be some selection bias there… also unsure how high compliance would be – would you always remember? #PHTwitJC
  25. I had to re-read to establish they hadn’t actually watched 1m ads -seems impossible, but would it have given them better data? #PHTwitJC
  26. @PHTwitJC probably would get better data, but highly impractical (although many adverts are repeats…?) #PHTwitJC
  27. Question 3: were the methods of comparing and analysing clear and appropriate?
  28. @PHTwitJC they are simple & clear (always good), but don’t take account of anything else that could have changed before/after #phtwitjc
  29. @rorymorr is there a way that contextual diffs could have been incorporated into analysis? #PHTwitJC
  30. @PHTwitJC there are a few things, but I they require data, can’t adjust for stuff if you aren’t measuring it. #phtwitjc
  31. @PHTwitJC having said that, for what they had, what they did seems fair enough, just limits a strong interpretation I think #phtwitjc
  32. @rorymorr so *ideally* you’d want data on ?advertising trends generally ?seasonal changes? #PHTwitJC
  33. @PHTwitJC yes, in an ecological design, I’d think generally the finer the temporal measurements (generally) the better. #PHTwitJC
  34. @PHTwitJC I mean, HFSS goes from 40% in Oct 2006 to 60% in July 07, no idea if that is normal, unusually large … etc #phtwitjc
  35. @rorymorr @PHTwitJC could this be to do with an increase in advertising generally or more HFSS foods on the market? #PHTwitJC
  36. @Claire_McLeod @PHTwitJC I think that increase is % HFSS ads of all food ads, which was interesting in itself #phtwitjc
  37. @PHTwitJC @rorymorr sorry, fmaily invasion, quieter now. get the impression info on ads/foods could have been more robust #PHTwitJC
  38. @PHTwitJC the bit that they found good adherence to the ad regulations – can be pretty confidence of that conclusion I think #phtwitjc
  39. @PHTwitJC *confident — the more general point about child exposure ‘unchanged’ I think is difficult to be sure about #phtwitjc
  40. @rorymorr yes, finding on regs adherence v clear, & fairly clear at least that kids still exposed to HFSS ads #PHTwitJC
  41. @PHTwitJC yes, that’s v.true, so even if you want to nitpick over details, you can still get broad picture of what’s going on #phtwitjc
  42. Q4: what are the implications of the study for public health policy? The authors state some- do you agree?
  43. @PHTwitJC I agree w/authors that study shows what happens with half-hearted restirctions = stricter rules needed for change #PHTwitJC
  44. @PHTwitJC highlights scale of obesity problem and the many dimensions & stakeholders involved. more research into ads def needed #PHTwitJC
  45. @PHTwitJC self reg & responsibility deal may not be adequate. would be interesting to compare to countries who have taken diff app#PHTwitJC
  46. @Claire_McLeod does shed light on likely impact of ‘responsibility deal’ (though pre-dates that explicit term) – 1/2 #PHTwitJC
  47. @PHTwitJC yes; small restriction motivates and enables adertisers to promote in diff ways vs. comprehensive restriction for all. #PHTwitJC
  48. @PHTwitJC Also categorising ‘pre-watershed’ assumes kids and parents abide by the ‘rule’ and I expect that many take no notice #PHTwitJC
  49. @PHTwitJC @carotomes totally agree, then there is social media, ads on facebook etc. but do we know extent marketing on health? #PHTwitJC
  50. Q5: what future research might be needed in the area?
  51. @PHTwitJC this won’t be very surprising to hear, but… time-series analysis! build up a consistent picture of exposure over time #phtwitjc
  52. Do we *know* that ads to kids affect health (>obesity) or is it enough evidence that advertisers resist changes? #PHTwitJC
  53. Discussion at the end of chat time returned to policy and practice issues; role of industry vis a vis public health:
  54. @Claire_McLeod @PHTwitJC this is an area which is not well understood, and #PublicHealth stands at a disadvantage vs industry #PHTwitJC
  55. @PHTwitJC I wonder if there are lessons to be learnt in looking back on reduction of smoking advertising over time #JustAThought #PHTwitJC
  56. @carotomes good point re smoking ad restrictions, though they were combined with other approaches to reduce tobacco use #PHTwitJC
  57. @PHTwitJC and the same multi-strand approach will be needed for obesity too, I expect! #PHTwitJC
  58. @PHTwitJC @carotomes massive taxes and bans on HFSS to come to address issue to extent of smoking??? #PHTwitJC
  59. @Claire_McLeod @PHTwitJC Hmmm fair point, unsure those same levers would work… but would love to try! #phtWITjc
  60. @carotomes true and as ever in #PH, will be difficult to disentangle the threads of influence /impact #PHTwitJC
  61. @PHTwitJC adverts effect choices, and kids have great pester-power! Choices are one-sided where healthy options not advertised #PHTwitJC
  62. Also another random thought; if we dedicated £££ to marketing health foods (e.g. apples) – would sales increase? Cost effective? #PHTwitJC
  63. @carotomes @PHTwitJC not industry apologist but they could resist changes for diff reasons (to compete within adult market) also #phtwitjc
  64. @carotomes @PHTwitJC just the fact they resist change not enough & also won’t be compelling enough to change all politico’s minds #phtwitjc
  65. Overall the paper seemed engaging and interesting. Participants had some queries about the design and therefore the accuracy of the results, but agreed that the paper established key issue: industry can keep to the letter of the law when restrictions are imposed, but they may get around limitations in other ways.
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