From the point-of-purchase perspective: a qualitative study of the feasibility of interventions aimed at portion-size.

OBJECTIVES Food portion-sizes might be a promising starting point for interventions targeting obesity. The purpose of this qualitative study was to assess how representatives of point-of-purchase settings perceived the feasibility of interventions aimed at portion-size. METHODS Semi-structured interviews were conducted with 22 representatives of various point-of-purchase settings. Constructs derived from the diffusion of innovations theory were incorporated into the interview guide. Each interview was recorded and transcribed verbatim. Data were coded and analysed with Atlas.ti 5.2 using the framework approach. RESULTS According to the participants, offering a larger variety of portion-sizes had the most relative advantages, and reducing portions was the most disadvantageous. The participants also considered portion-size reduction and linear pricing of portion-sizes to be risky. Lastly, a larger variety of portion-sizes, pricing strategies and portion-size labelling were seen as the most complex interventions. In general, participants considered offering a larger variety of portion-sizes, portion-size labelling and, to a lesser extent, pricing strategies with respect to portion-sizes as most feasible to implement. CONCLUSIONS Interventions aimed at portion-size were seen as innovative by most participants. Developing adequate communication strategies about portion-size interventions with both decision-makers in point-of-purchase settings and the general public is crucial for successful implementation.

[1]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[2]  M. Nestle,et al.  The contribution of expanding portion sizes to the US obesity epidemic. , 2002, American journal of public health.

[3]  B. Rolls,et al.  Increasing the portion size of a sandwich increases energy intake. , 2004, Journal of the American Dietetic Association.

[4]  Julia A. Ello-Martin,et al.  Portion sizes and the obesity epidemic. , 2011, The Journal of nutrition.

[5]  B. Popkin,et al.  Patterns and trends in food portion sizes, 1977-1998. , 2003, JAMA.

[6]  J. Brug,et al.  Environmental determinants and interventions for physical activity, nutrition and smoking: A review , 2005 .

[7]  K. Ball,et al.  Socioeconomic status and weight change in adults: a review. , 2005, Social science & medicine.

[8]  S. Ziebland,et al.  Analysing qualitative data , 2000, BMJ : British Medical Journal.

[9]  B. Rolls,et al.  The Effect of Large Portion Sizes on Energy Intake Is Sustained for 11 Days , 2007, Obesity.

[10]  D. Mitchell,et al.  Foods commonly eaten in the United States, 1989-1991 and 1994-1996: are portion sizes changing? , 2003, Journal of the American Dietetic Association.

[11]  B. Rolls,et al.  Increasing the portion size of a packaged snack increases energy intake in men and women , 2004, Appetite.

[12]  J. Peters,et al.  Environmental contributions to the obesity epidemic. , 1998, Science.

[13]  Laura Johnson,et al.  How Many Interviews Are Enough? , 2006 .

[14]  Willem van Mechelen,et al.  Worksite health promotion programs with environmental changes: a systematic review. , 2005, American journal of preventive medicine.

[15]  Gösta Samuelson,et al.  Global strategy on diet, physical activity and health , 2004 .

[16]  B. Rolls,et al.  Portion size of food affects energy intake in normal-weight and overweight men and women. , 2002, The American journal of clinical nutrition.

[17]  I. Steenhuis,et al.  The impact of educational and environmental interventions in Dutch worksite cafeterias. , 2004, Health promotion international.

[18]  L. Ovesen,et al.  Size makes a difference , 2003, Public Health Nutrition.

[19]  Sue Ziebland,et al.  Analysing qualitative data , 2000, BMJ : British Medical Journal.

[20]  B. Wansink,et al.  At the movies: how external cues and perceived taste impact consumption volume , 2001 .

[21]  G. Parcel.  Diffusion research: the Smart Choices Project , 1995 .

[22]  B A Swinburn,et al.  Diet, nutrition and the prevention of excess weight gain and obesity , 2004, Public Health Nutrition.

[23]  Lawrence D. Frank,et al.  Healthy Nutrition Environments: Concepts and Measures , 2005, American journal of health promotion : AJHP.

[24]  R. Jeffery,et al.  Effects of portion size on chronic energy intake , 2007, The international journal of behavioral nutrition and physical activity.

[25]  R. Jeffery,et al.  Environmental influences on eating and physical activity. , 2001, Annual review of public health.

[26]  J. Seidell,et al.  Portion size: a qualitative study of consumers' attitudes toward point-of-purchase interventions aimed at portion size. , 2010, Health education research.

[27]  B. Swinburn,et al.  Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. , 1999, Preventive medicine.

[28]  B. Wansink.  Can Package Size Accelerate Usage Volume? , 1995 .

[29]  R. Sturm,et al.  The effects of obesity, smoking, and drinking on medical problems and costs. , 2002, Health affairs.

[30]  K. Glanz,et al.  Environmental and Policy Approaches to Cardiovascular Disease Prevention Through Nutrition: Opportunities for State and Local Action , 1995, Health education quarterly.

[31]  B. Rolls,et al.  Increased portion size leads to increased energy intake in a restaurant meal. , 2004, Obesity research.