Monitoring of Marketing of Unhealthy Products to Children and Adolescents – Protocols and Templates
Faith Kilford Vorting
- Introduction
- Food marketing monitoring guidance and support
- 1. Food marketing monitoring in all media
- 2. TV Monitoring Protocol and Templates
- 3. Internet Monitoring Protocol and Templates
- References
Introduction
Exposure to advertising of foods and drinks high in sugar, fat and salt (HFSS) is associated with children’s preferences and, ultimately, with childhood overweight and obesity. In May 2010, the World Health Assembly unanimously adopted the WHO Set of Recommendations on the Marketing of Foods and Non-alcoholic Beverages to Children. These recommendations urge Member States to reduce the impact of the marketing of energy-dense, highly processed HFSS foods and beverages on children. These recommendations were reinforced by the WHO Commission on Ending Childhood Obesity and the Global Action Plan for the Prevention and Control of NCDs 2013–2020.
Practising responsible marketing is also recommended for other unhealthy products, such as alcoholic drinks and tobacco, including new products such as electronic cigarettes (e-cigarettes) and other types of electronic nicotine-delivery systems. The WHO Framework Convention on Tobacco Control requires Parties to adopt a comprehensive ban on all forms of tobacco advertising, promotion and sponsorship. The European Commission regulations for tobacco also explicitly ban Internet marketing. The WHO European Action Plan to Reduce the Harmful Use of Alcohol 2012–2020 requires countries to implement systems to prevent inappropriate and irresponsible alcohol advertising and marketing targeting children and young people.
Unhealthy marketing infringes multiple rights under the United Nations Convention on the Rights of the Child, including the rights to health, and can be considered as a form of economic exploitation.
Monitoring the marketing of unhealthy products to children and adolescents is fundamental to encouraging and sustaining the implementation of regulations and restrictions by Member States. To strengthen monitoring and evaluation, the World Health Organization Regional Office for Europe has developed the following training unit that includes protocols and tools.
Food marketing monitoring guidance and support
The Regional Office’s training unit provides protocols and templates for monitoring food marketing in audiovisual media (TV and Internet). The unit covers manual methods that are relatively simple and low-cost but also indicates where more complex or costly methods could also be considered (such as those requiring data purchase). All templates can be adapted to individual countries to ensure the best possible study is conducted within the specific circumstances (taking account of cost, feasibility and researcher time).
This unit provides:
- an overview of key issues in psychological and marketing research as they relate to the evaluation of food marketing exposure, power and impact on children of all ages;
- step-by-step protocols for conducting monitoring;
- coding templates with variables to measure exposure and power in marketing;
- examples of completed coding on templates with associated explanations to support learning about the coding process (on request);
- guidance for statistical analyses;
- templates for writing official reports and/or journal articles to communicate the findings; and
- optional training in monitoring study design and methods.
The unit is designed to be a living package of resources. When updates to the contents are made, they will be dated with a new version number.
This unit and tools were developed by Dr Emma Boyland (University of Liverpool, United Kingdom) and Dr Mimi Tatlow-Golden (The Open University, United Kingdom) in collaboration with the WHO Regional Office for Europe. Ms Anna Coates (University of Liverpool, United Kingdom) contributed to the Influencer protocol.
1. Food marketing monitoring in all media
Specific protocols and templates have been developed for monitoring food marketing in different media channels – TV and digital media – and these are presented separately. However, the Regional Office training unit provides some content relevant for monitoring food marketing in any media in the WHO Europe Nutrient Profiling Model (NPM) Decision Tree and training templates and presentations, presented below.
WHO Europe Nutrient Profiling Model (NPM) Decision Tree
Nutrient profiling is the science of classifying or ranking foods according to their nutritional composition for reasons related to preventing disease and promoting health. Its use in food marketing monitoring allows differentiation between the advertising of foods and non-alcoholic beverages that are more likely to be part of a healthy diet from those that are less likely (that is, those foods that may contribute to excess consumption of energy, saturated fats, trans fats, sugar and salt).
A decision tree for nutrient profile modelling is provided, including a step-by-step guide to deciding whether the marketing of an advertised product is permitted or not according to its nutrient profile and the categories of the WHO NPM.
Training from the WHO monitoring team
Some training from the WHO monitoring team is recommended, given that:
- the decision-making process to identify optimal monitoring methods can be complex, particularly in digital media;
- there is a need to ensure coding is consistent with demonstrable reliability; and
- protocols and templates may require adaptation to ensure cultural relevance (for instance, use of WHO NPM specific to regions other than Europe, and adaptations of codes to reflect marketing themes in a particular region).
Training can be done remotely or at face-to-face workshops. The duration of training recommended depends on prior experience and the type of monitoring to be undertaken, but typically 1.5–2 days is sufficient (whether in a single session or broken up into smaller segments). A template training programme is provided with basic frameworks that can be adapted and tailored to meet Member States’ needs.
Additionally, to support Member States in understanding the scientific theory and evidence behind this issue, some presentations are also provided, introducing psychological and marketing research.
For further support for the WHO training unit or any queries related to the protocols and templates provided, please contact the WHO NCD Office: ncdoffice@who.int
2. TV Monitoring Protocol and Templates
2.1 TV Monitoring Protocol V2 2020
This protocol sets out a methodological approach for countries wishing to gather evidence to support policy deliberations around the marketing of unhealthy foods and beverages to children, as well as the coding and handling of the data acquired. Questions this protocol helps to answer include the following.
- How much food and beverage advertising are children (under 18 years of age) likely to be exposed to on TV?
- What foods and beverages are advertised?
- How powerful is the advertising to potentially influence behaviour (for example, what techniques are used)?
2.2 TV Monitoring Decision Tree
This template contains a monitoring decision tree for TV advertisements with a step-by-step guide on how to gather data on the most popular commercial TV channels watched by children. The decision tree provides guidance on the order of actions required to implement the monitoring framework for each country (where to start, which questions to ask and which decisions are made individually according to available resources).
2.3 TV Coding Template V2 2020
This template is a downloadable Excel spreadsheet into which coding can be entered directly. The template has columns for all the necessary information to be captured (including the nutrient profile of the advertised product), and descriptions of all codes are provided on the second sheet.
The exposure variables capture the country, channel, date marketing occurred/recorded, programme category, name and start time, advertised product type and additional details of all food or beverage advertisements.
The power variables capture the creative content of the advertising, including the use of persuasive appeal(s), musical jingles or characteristic melodies, dynamic audiovisual components, brand equity characters, licensed characters, celebrity endorsers, premium offers, sponsorship, website addresses, links to social media platforms, brand logos, images of packaging and products, and health claims.
2.4 TV Example Coding
To help Member States in performing such analysis, the WHO monitoring team coded 4 example advertisements. This process is fully described in separate documents:
- a PowerPoint presentation with 4 example advertisements;
- an Excel spreadsheet with an example of coding of these 4 example advertisements, with exposure and power variables completed; and
- a document with an explanation of the decision-making that underpinned the example coding provided.
To access the example coding files, please contact the WHO NCD Office: ncdoffice@who.int
3. Internet Monitoring Protocol and Templates
This section outlines Internet monitoring methods for food marketing and contains the following tools.
3.1 Internet Monitoring Protocol V2 2020
This protocol presents the purposes of monitoring Internet marketing to which children are exposed and methods to identify the exposure and power of such marketing. The protocol is split into 2 major parts: a preparation stage, followed by data collection and analysis covering multiple approaches. It explains how to identify children’s media practices and the key brands in a certain region and how to gather data from multiple sources. The combination of these approaches allows estimations to be built of the products, brands and strategies to which children are most likely to be exposed.
3.2 Internet Coding Template V2 2020
This template contains multiple Excel spreadsheets to allow coding of multiple forms of Internet marketing. Currently, these are: (1) social media brand page; (2) websites; (3) YouTube brand channels; and (4) YouTube influencers.
Codes assess both the exposure and the power of the advertisement.
Exposure variables capture data on, for example, the country and brand/product pages, including the followers/likes, the time and date of the advertisement, WHO NPM food category code and nutritional information.
Power variables capture data on, for example, the type of marketing content, views, reactions, shares, brand image, audiovisual components, primary and secondary persuasive appeal, any celebrity endorsers and links to other social media platforms.
3.3 Internet Social Media Brand Page Protocol V2 2020
This protocol is a step-by-step explanation for how to analyse marketing posts on food and beverage brand pages in social media (such as Facebook). It explains how to identify which products and brands to assess, how to locate the product or brand page, how to record products or brand posts, and how to carry out a content analysis.
3.4 Internet Social Media Brand Page Example Coding
The WHO monitoring team provides 4 example advertisements to explain how to conduct social media brand page coding, detailed in the following documents:
- an Excel spreadsheet with an example of coding of these 4 example advertisements, with exposure and power variables completed; and
- a document with an explanation of the decision-making that underpinned the example coding provided.
To access the example coding files, please contact the WHO NCD Office: ncdoffice@who.int
3.5 Internet Website Brand or Product Protocol V2 2020
This template describes the steps involved in analysing the websites of food or beverage products or brands. It explains how to identify which products or brands to assess, how to locate the product or brand website, how to record product or brand website content, and how to code the web content using the associated spreadsheet on the Excel template (2.1). It provides a step-by-step guide on how to undertake each of the above-mentioned steps with an easy-to-follow protocol.
3.6 Internet YouTube Brand Channel Protocol V2 2020
This protocol contains a description of the steps involved in analysing the food marketing found on the Internet on a food or beverage product or brand channel on media-sharing sites such as YouTube. It explains how to identify products or brands to assess on media-sharing sites, how to locate the product or brand page, how to identify the most popular videos, how to carry out nutrient profile analysis and how to conduct content analysis. It provides a step-by-step guide on how to undertake each of the above-mentioned steps with an easy-to-follow protocol. To carry out the coding, use the associated spreadsheet on the Excel template (2.1).
3.7 Internet YouTube Influencer Protocol V2 2020
This protocol describes the methods to use to explore the prevalence and context of food and beverage cues featured in YouTube videos on social media influencer channels. It explains how to identify influencers and videos to assess in YouTube, how to locate the videos and how to code the food cues. To carry out the coding, use the associated spreadsheet on the Excel template (2.1).
The exposure variables capture the influencer, influencer sex, number of subscribers, YouTube video link, date the video was uploaded, duration of video, date the video was coded, start and end time, food product brand name, description of food product and WHO NPM food category code.
The power variables capture the cue brand status, context, description, presentation and why the cue was featured.
References
Set of recommendations on the marketing of foods and non-alcoholic beverages to children (2010)
WHO Commission on Ending Childhood Obesity
Global action plan for the prevention and control of noncommunicable diseases 2013-2020
WHO Framework Convention on Tobacco Control (2003)
The European Commission regulations for tobacco
European action plan to reduce the harmful use of alcohol 2012–2020
The United Nations Convention on the Rights of the Child
