Health advertising to promote fruit and vegetable intake: Application of health-related motive segmentation

Available online at www.sciencedirect.com

Food Quality and Preference 19 (2008) 481–497 www.elsevier.com/locate/foodqual

Health advertising to promote fruit and vegetable intake: Application of health-related motive segmentation Nele Geeroms a,*, Wim Verbeke b, Patrick Van Kenhove a b

a Ghent University, Department of Marketing, Tweekerkenstraat 2, B-9000 Gent, Belgium Ghent University, Department of Agricultural Economics, Coupure links 653, B-9000 Gent, Belgium

Received 30 June 2007; received in revised form 27 November 2007; accepted 15 February 2008 Available online 21 February 2008

Abstract The purpose of this study was to identify subgroups within a population on the basis of their health-related motive orientations (HRMO). Participants were 615 consumers between the ages of 17 and 77, drawn from the Dutch-speaking part of Belgium. They provided ratings of 45 health statements referring to people’s motives for health, i.e., those things that give health meaning. We also obtained information on daily intake of fresh fruits and vegetables (F&V) by using a short food frequency scale. In addition, we asked the respondents to provide evaluative ratings of four targeted F&V health advertisements, which differed from each other on two dimensions, i.e., message tonality (informational vs. transformational) and directionality (self-directed vs. other-directed). As a benchmark, we used an existing Belgian public health campaign that had a more general character. Based on a two-step cluster analysis, we identified 5 distinct subgroups in the sample, with different HRMO: health is about energy (Energetic Experimenters), emotional well-being (Harmonious Enjoyers), social responsibility (Normative Carers), management/outward appearance (Conscious Experts) and physical well-being/ functionality (Rationalists). Besides differences in (category-specific) F&V consumption among these segments, also different types of advertising messages are appropriate for each of the subgroups, i.e., transformational/self-directed for the Energetic Experimenters, transformational/other-directed for the Harmonious Enjoyers, informational/other-directed for the Normative Carers and informational/self-directed for the Conscious Experts/Rationalists. Moreover, the segments provided more positive evaluations of the most appropriate targeted advertisement compared to the benchmark advertisement, which stresses the benefits of targeted F&V advertising strategies over and above more general messages. Ó 2008 Elsevier Ltd. All rights reserved. Keywords: Advertising; Consumer; Fruit and vegetables; Health; Motive; Segmentation

1. Introduction Consumption of diets rich in fruits and vegetables (F&V) has extensively been demonstrated to be important for attaining and maintaining a good health (Cox et al., 1996; Steinmetz & Potter, 1996; Van Duyn & Pivonka, 2000). The World Health Organization (WHO, 1990) recommends a daily intake of at least 400 g of F&V, which is equivalent to about five 80 g portions of F&V per day. Nevertheless, consumption statistics show that the con*

Corresponding author. Tel.: +32 9 264 35 27; fax: +32 9 264 42 79. E-mail address: [email protected] (N. Geeroms).

0950-3293/$ - see front matter Ó 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.foodqual.2008.02.004

sumption levels of fresh F&V remain substantially below this recommended level in many countries (Naska et al., 2000; Verbeke & Pieniak, 2006). To promote compliance with the ‘‘Five-a-day” recommendation, several nation-wide public health campaigns have been established with varying results. Whereas some of the interventions actually did achieve the meant objectives (French & Stables, 2003), to date, the majority of nutrition interventions aimed at promoting increased F&V consumption have met with modest success at best (Glanz & Yaroch, 2004; Mangunkusumo, Brug, de Koning, van der Lei & Raat, 2007; Weaver, Poehlitz & Hutchison, 1999).

482

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

At least partly, this modest success of public health campaigns may be due to a disregard of the possibility that the total population consists of a number of smaller subgroups with distinct need patterns that should be targeted (Albrecht & Bryant, 1996; Verbeke, 2005). Besides its usefulness in commercial marketing areas, the significance of audience segmentation is acknowledged in social marketing as well, especially for designing tailored health marketing campaigns that are responsive to the individual needs and motives of the target audience (Forthofer & Bryant, 2000; Freimuth, Cole & Kirby, 2001; Slater & Flora, 1994). As demographic or psychographic homogeneity alone provides precious little help in constructing tailored health advertisements (Slater, 1995), this study proposes a domain-specific segmentation scheme based on people’s health-related motive orientations (HRMO), i.e., psychological meanings that people attribute to health and that motivate health behavior. The meaning of health from a layperson’s perspective has already been addressed in a number of previous studies (Hughner & Kleine, 2004; Lindholm, 1997; Ogden, 2007). These studies support the conceptualization of health as a multidimensional construct, comprising a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. We adopt this multidimensional perspective on health by considering several psychosocial health motive dimensions, such as emotional well-being, feeling happy, being with friends, social responsibility, having energy, looking good and self-management, beyond the level of physical health only. Moreover, we go beyond previous conceptualization literature by introducing these HRMO as relevant segmentation variables in a food choice behavioral context. Though health beliefs or concerns have been identified as important motivators of people’s food choice behavior such as F&V intake (Contento, Michela, & Goldberg, 1988; Roininen et al., 2001; Schifferstein & Oude Ophuis, 1998), from a multifaceted interpretation of health, insufficient attention has been paid to differences in health perception between individuals and thus to the possibility that several subgroups may exist within a population for which health has another distinct meaning. The latter has been stated by St Claire et al. yet in 1996, but to date, we are not aware of any studies that fully capture this gap in literature. However, differences in the meaning of health among people may account for significant behavioral differences and, thus, nutrition education may benefit from developing tailored intervention campaigns that capture these health-related motivations of the subgroups. Hence, in the present study, we explicitly propose a new segmentation scheme based on people’s subjective perceptions of the meaning of health. Besides identifying distinct consumer segments and assessing differences in F&V consumption among these segments, the purpose of this study is to explore the potential effectiveness of different targeted health advertisements that aimed at motivating each of these segments to increase

their F&V intake. In response to different HRMO, two advertising content dimensions were manipulated in this study, i.e., message tonality (informational vs. transformational) and directionality (self-directed vs. other-directed) and four targeted health advertisements were created that employ combinations of these dimensions. Additionally, a fifth general (general, i.e., not responsive to people’s HRMO) advertisement was included that was part of an existing Belgian public health campaign and that we used as a benchmark to compare with the targeted or consumer-oriented health advertisements. 2. Methods To meet the objectives, a large-scale consumer survey was undertaken in the Dutch-speaking part of Belgium by using an on-line survey method. A link to the questionnaire was placed on the website of a widespread national newspaper. Ensuring that repeated participation was impossible, a sample of 692 subjects was collected, from which 77 respondents were eliminated because of incomplete responses on key variables, thus yielding a final valid sample of n = 615. The respondents ranged in age from 17 to 77 years, with a mean age of 40.7 (SD = 12.6). Compared with the available population statistics of the Belgian people (NIS, 2005), the sample was representative in terms of age, relationship status and children in the family. With regard to gender, women were slightly overrepresented (59.0%) as were people with a higher education (59.4%). A detailed overview of the sample characteristics is presented in Table 1. 2.1. Measurement of health-related motive orientations In Appendix B an overview is given of the scale that was used to measure people’s health-related motive orientations. This scale consisted of 45 items. 15 items talked about health in a rather explicit way (i.e., meaning of health or people’s reasons for striving for a good health) whereas the other 30 items dealt with health more implicitly by focusing on perceived consequences of a bad health. Respondents rated these items on a 7-point Likert scale going from 1 = totally disagree to 7 = totally agree. All items were constructed based on desk research and previous qualitative research, more specifically 18 in-depth interviews and three group discussions in which participants were encouraged to talk about their subjective perceptions of the meaning of health. Though a detailed explanation of the latter research is beyond the scope of this article (for details we refer to the Synovate/Censydiam (2004) report which is available in English on request), at least six health-related motive dimensions should be mentioned as emerging out of this exploratory investigation: health is about energy, health is about emotional well-being and enjoying life, health is about social responsibility, health is about physical well-being, health is about self-manage-

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497 Table 1 Sample characteristics (% of respondents, N = 615) Sample

Population*

Gender Male Female

41 59

48.9 51.1

Age <25 25–40 40–50 >50 Mean

11.4 39.6 23.7 25.3 40.7

18.4 32.8 22.6 26.2

Education Lower education (age of 18)

40.6 59.4

67.4 32.6

Profession Labourer Employee Executive Self-employed Functionary Keeping house Retired Unemployed Student Others

7.0 41.2 6.6 4.8 11.9 6.1 9.4 2.9 6.4 3.8

Relationship status Single Relationship/married

22.6 77.4

27.1 72.1

Children in family No (=no children) Yes (=children)

37.3 62.7

35.1 64.9

Employment Status Part time employed Full time employed Not applicable

14.4 58.9 26.7

483

(see Table 2). Scores of each item were summed and averaged to represent the corresponding health construct. These composite construct measures were used in all further analyses, most specifically as the basis for determining health-related motive segments. 2.2. Stimuli selection

* Source: NIS (2005). Private households statistics. Brussels: NIS, National Institute for Statistics.

ment, and health is about outward appearance. Each of these health interpretations was translated in a series of health statements that made up the items in the Healthrelated Motive Scale. As a result, six health constructs were supposed to underlie this scale. To evaluate unidimensionality and convergent validity of the hypothesized scale dimensions, a maximum likelihood confirmatory factor analysis (CFA), using Lisrel 8.50 was performed with six health constructs (Jo¨reskog & So¨rbom, 1993). After dropping some items that did not perform well (N = 11), a satisfactory six-factor model emerged out of this analysis (see Table 2). To test discriminant validity, each of the 15 off-diagonal elements of U was fixed to 1.0, in turn, and the model was re-estimated. Changes in the v2 goodness-of-fit were statistically significant for all 15 comparisons (Dv2 ranging from 211 up to 252, df = 1, p < 0.05) (Steenkamp & Van Trijp, 1991). Construct reliabilities were evaluated by calculating the composite reliabilities. Reliabilities of the six multiple-item scales were satisfactory as they ranged from 0.61 to 0.82

The choice of manipulating tonality (informational vs. transformational) and directionality (self-directed vs. other-directed) as advertising content dimensions was driven by the fact that both are well-established communication dimensions in literature (De Pelsmacker, Geuens & Van den Bergh, 2007), which may account for different behavioral reactions among segments according to different health-related motive orientations. Hence, these content aspects were combined to create the four targeted F&V health advertisements (2-by-2 within-subjects design). The tonality dimension was manipulated by using an informational versus transformational advertising strategy (Rossiter & Percy, 1997). The transformational ads used vivid pictures (either self-directed or other-directed depending upon the particular condition), paid attention to hedonic aspects of F&V consumption (e.g., enjoying life, experiencing freedom) and put sentences in first-person wording (either singular (I-sentences) or plural (we-sentences) depending upon the condition) as their primary aim is to evoke emotions in consumers by making use of rather personal, emotional stimuli. The informational ad versions used mainly verbal arguments, paid attention to the functional benefits of F&V (e.g., avoiding illness or avoiding getting obese) and wrote sentences in rather removed third-person wording. These advertisements aim to make people think by using rational information cues and focusing on functional consumer motives such as solving or avoiding a particular problem. Directionality was manipulated by using either self-directed arguments emphasizing the themes of self-identity, individuality, unique lifestyle and private issue or other-directed arguments focusing on the theme of we-ness, relationship, family-commitment and joint decision (Wang & Mowen, 1997). The fifth, general advertisement that was included in the study had both a more neutral tonality (neither informational nor transformational) and directionality (neither self-directed nor other-directed) and was taken from an existing F&V public health campaign, which was running at the time of the research. All five stimuli advertisements are shown in Appendix A. 2.3. Dependent measures 2.3.1. Fruit and vegetable (F&V) consumption To estimate consumer’s intake of fresh F&V, a short food frequency questionnaire (FFQ) was used, developed and validated by Bogers, Van Assema, Kester, Westerterp

484

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

Table 2 Results of confirmatory factor analysis: measurement model Health construct Measurement model (measures) 1. Health = energy 2. Health = emotional well-being 3. Health = social responsibility 4. Health = physical well-being 5. Health = management 6. Health = outward appearance

Original number of Items

Final number of Items

Item labels*

Composite reliability

7 11

5 7

0.77 0.70

5

5

Exp1, Exp2, Exp6 Imp17, Imp29 Exp3, Exp13, Exp14 Imp4, Imp15, Imp21, Imp23 Exp4, Exp7 Imp1, Imp12, Imp25

10

7

0.61

4 8

4 6

Exp5, Exp8, Exp11 Imp2, Imp8, Imp11, Imp22 Imp6, Imp20, Imp27, Imp28 Exp10, Exp12 Imp7, Imp14, Imp16, Imp30

0.62

0.70 0.82

Measurement model (fit indices) NNFI 0.90 RMR 0.069 RMSEA 0.062 GFI 0.87 *

For the full text item labels see Appendix B.

and Dagnelie (2004). This instrument had a reference period of 1 month and included those types or categories of F&V that were consumed most frequently in Belgium. Participants were asked to indicate for each category, both their average consumption frequency and portion size. Consumption frequency was measured on a 9-point scale going from 1 = never or less than 1 day a month to 9 = 7 days a week. To indicate portion size, a 5-point scale was used ranging from 1 = 1 serving to 5 = 5 or more servings. Depending on the category of F&V, serving size was operationalized as either one 50–60 g serving spoon (e.g., cooked vegetables), one piece (e.g., bananas) or one glass (e.g., fruit juices). Total intake, expressed in number of servings per day, was calculated by multiplying consumption frequency with portion size. Consumption of the various F&V categories was summed to obtain total fruit consumption, total vegetable consumption, and total F&V intake. 2.3.2. Attitude toward the ad (Aad) and behavioral intention (BI) People’s evaluations of the five stimuli advertisements were measured by a five-item Attitude Toward the Ad Scale (Aad) and a single-item Behavioral Intention Scale. With regard to Aad, three items were based on Zinkhan, Locander, and Leigh (1986) (i.e. ‘I like this ad’, ‘I consider this ad to be good’, ‘This ad appeals to me’) and the other two items were taken from the Attitude Toward the Ad scale of Burke and Edell (1989) (‘This ad is convincing to me’, ‘This ad is relevant for me’). All items ranged from 1 = totally disagree to 8 = totally agree. For all five advertisements, the five-item scale reliabilities were very good. Cronbach’s Alpha’s ranged from 0.94 to 0.96, all exceeding the lower critical value level of 0.60. So, in each case, the scores of the five items were summed and averaged to form a composite measure of Aad.

Effects in terms of behavioral intention were also measured for all five advertisements. Concretely, subjects were asked to indicate the likelihood of eating more fresh fruits and vegetables (i.e. ‘This ad will prompt me to eat more F&V in the future’) on an 8-point likelihood scale ranging from 1 = not at all likely to 8 = very likely. 2.4. Manipulation checks Additionally, two manipulation checks were included in the questionnaire. These measures asked about how people perceived a particular health advertisement in terms of tonality (informational vs. transformational) and directionality (self-directed vs. other-directed), respectively. Informational and transformational ad content was measured with three semantic differential items that were based on the standard scale of Puto and Wells (1984): objective vs. experience-oriented information; formal vs. informal; rational vs. emotional. Self-directedness and other-directedness were also measured with three semantic differentials derived from Wang and Mowen (1997): individualistic vs. altruistic; self-identity vs. family commitment; ego-ness vs. we-ness. In both cases, each semantic differential used a 5-place scale response format. Tonality and directionality scores were derived by averaging over the corresponding items, such that higher scores reflect higher transformationality and other-directedness, respectively. ANOVA results indicated that both our tonality and directionality manipulations had been successful. Transformational advertisements were perceived as significantly more ‘transformational’ compared to the informational advertisements (M = 3.9 vs. M = 2.6; F(1, 6 1 1) = 295.21, p < 0.05). Also, other-directed advertisements were perceived as significantly more ‘other-directed’ compared to the self-directed advertisements (M = 3.9 vs. M = 2.5; F(1, 6 1 1) = 429.57, p < 0.05).

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

3. Results 3.1. Segmentation To identify segments according to perceptions of the meaning of health, a two-step cluster analysis (hierarchical clustering using Ward’s method, followed by a Kmeans clustering) was performed on the six health constructs that represent people’s health-related motive orientations. A number of cluster solutions were initially specified (ranging from four to eight) and the solutions evaluated. Out of this evaluation, a five-cluster solution was identified as best explaining the data (see Table 3) based on variable mean scores, i.e., a 5-cluster solution represented the most parsimonious grouping structure of the sample population; cluster sizes, i.e., a 5-cluster solution provided the most substantial number of members in each group; interpretability of the results, i.e., a 5-cluster solution provided the most straightforward and interpretable results; and the error sum-of-squares criterion (ESS), i.e., a substantial increase in ESS could be found at a transition stage from five to four clusters, which indicates that a 5-cluster solution is most appropriate as further reducing the number of clusters (to four or less) may result in too much variation/heterogeneity within these clusters (Hair, Black, Babin, Anderson, & Tatham, 2006). A correspondence analysis (FCA) – based on a contingency table including, in absolute values, the number of respondents per cluster that associate the meaning of health with a particular health statement – revealed the health-related motive structure as depicted in Fig. 1. The vertical axis of this structure reflects an intrapersonal dimension as it refers to the way in which the individual translates health for himself. On the one hand health gets meaning throughout its emotional aspects of enjoyment and freedom, whereas on the other hand, health is perceived in a very physical manner with a focus on functionality and control. The horizontal axis refers to an

485

interpersonal health perception as it shows how the fundamental meaning of health is related to the social environment. An altruistic, normative way of perceiving health could be discovered with a focus on social well-being and responsibility, in contrast to a more individualistic interpretation of health, focusing on feelings of independence of others and activity. Out of the dynamic interaction of both dimensions, five consumer segments emerge as the result of the cluster analysis, with different health-related motive orientations. In the sections below a detailed description is provided for each of these five segments, based on their variable mean scores (Table 3) and clusteritem associations (Fig. 1). 3.1.1. Segment 1: Energetic Experimenters (34%) Members of this segment perceive health mainly in terms of vitality and energy (M = 6.0). Half of them (50.7%) associate health with ‘living an active life’; 49.3% with ‘keeping the body in a good condition’ and 42.0% would perceive it as (extremely) bad not to be able anymore to practice sports because of health problems. Energetic Experimenters have an average age of 37.7, i.e., the youngest segment, and compared to the total sample (41.0%), males are slightly overrepresented in this segment (52.7%). About 43.0% of Segment 1 is working as an employee, 49.5% has no children (which is more than the other segments) and 65.2% has a fulltime employment status. Accounting for 34% of the total sample, Energetic Experimenters are the largest segment. 3.1.2. Segment 2: Harmonious Enjoyers (16%) These people are mainly involved with emotional health (M = 5.8). ‘Emotional well-being’ (75.2%); ‘enjoying life’ (67.3%) and ‘keeping up good social contacts’ (32.7%) are very important to them. Compared to the other segments, Harmonious Enjoyers are slightly older (average age 43.9) with more retired people (19.0%). Most of them have children (67.3%) and here also, males are somewhat overrepresented compared to the total sample (48.5%).

Table 3 Means and standard deviations for a five-cluster solution Health constructs*

Total sample

Cluster 1 (Energetic Experimenters)

Cluster 2 (Harmonious Enjoyers)

Cluster 3 (Normative Carers)

Cluster 4 (Conscious Experts)

Cluster 5 (Rationalists)

Health = energy Health = emotional well-being Health = social responsibility Health = physical well-being Health = management Health = outward appearance

4.5 (1.59) 5.2 (0.88)

6.0 (0.76) 5.1 (0.83)

4.1 (1.12) 5.8 (0.62)

2.7 (1.14) 5.4 (0.70)

4.4 (1.06) 4.8 (0.95)

3.0 (0.96) 4.9 (0.94)

5.2 (0.94)

4.8 (1.00)

5.3 (1.06)

5.8 (0.68)

5.0 (0.87)

5.3 (0.71)

5.3 (0.81)

4.8 (0.78)

5.2 (0.77)

5.7 (0.57)

5.0 (0.80)

5.7 (0.61)

3.7 (1.22) 3.5 (1.25)

3.5 (1.20) 3.3 (1.09)

2.9 (1.05) 2.2 (0.68)

3.0 (1.01) 2.5 (0.79)

5.4 (0.89) 5.6 (0.62)

3.7 (1.19) 3.8 (1.00)

N = 615

N = 207

N = 101

N = 104

N = 109

N = 94

*

For the items of the scales for the health constructs: 1 corresponds to ‘totally disagree’ and 7 corresponds to ‘totally agree’.

486

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

Fig. 1. Health-related motive structure. * To be able to perform a FCA, we made a binary version of the 7-point Likert scale on which the 45 health statements were measured, by recoding the values 1 through 3 to 0 (i.e., a particular health statement is NOT associated with the meaning of health for the respondent) and the values 4 through 7 to 1 (i.e., a particular health statement IS associated with the meaning of health for the respondent). As an input matrix for the FCA, we created a contingency table which included, in absolute values, the number of respondents per cluster that associate the meaning of health with a particular health statement (i.e., those respondents who scored the value 1 on a particular statement). The percentages between brackets in the above figure were computed by dividing these absolute numbers by the total number of respondents in the corresponding cluster.

3.1.3. Segment 3: Normative Carers (17%) In contrast to Harmonious Enjoyers, members of Segment 3 are heavily concerned with the physical aspects of health (M = 5.7). Being healthy means in particular ‘avoiding illness’ and ‘having no physical health problems’ (50.6%). In addition, Normative Carers perceive health as a social responsibility (M = 5.8). ‘Taking care of other family members’ health’ (29.9%), is considered as very important. Most of the people in Segment 3 are women (59.7%) with an average age of 43.6. More than the other segments Normative Carers work at home (14.3%).

3.1.4. Segment 4: Conscious Experts (18%) For respondents in Segment 4 health is mainly about management (M = 5.4) and physical appearance (M = 5.6). They deal with health in a very self-conscious way with the focus on the health of their own body. As opposed to the other segments, ‘staying slim’ (24.8%); ‘looking good’ (10.1%); ‘being stylish’ are very important aspects of feeling healthy for members of Segment 4. They know their own body the best and as a result, they want to manage their health by themselves, without needing advice from others. Among them, the majority are women (74.1%), fulltime employed (63.3%) and 41.3% works as

an employee. The average age of this second youngest segment is 40.2 years. 3.1.5. Segment 5: Rationalists (15%) Similar to Normative Carers, members of Segment 5 are engaged with the physical/functional aspects of health (M = 5.7), but with as main objective ‘having the competence to do their job’ (27.7%) and ‘being able to organize life and to work functionally’ (41.5%), rather than ‘taking care of the health of others’. These ‘Rationalists’ represent 15% of the total sample. Women are highly overrepresented in this segment (75.3%) with a mean age of 41.9 years. Most of them are employees (52.1%) with a fulltime employment status (54.3%). 3.2. Fruit and vegetable (F&V) consumption ANOVA results revealed no significant differences between the five consumer segments regarding total F&V intake (F(4, 5 5 2) = 0.85, p > 0.05), as all cluster means fluctuated tightly around the sample mean of 5.4 servings a day. However, significant differences could be detected between the segments regarding category-specific F&V intake. In particular, Energetic Experimenters (M = 0.7)

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

consumed significantly more bananas than did Harmonious Enjoyers (M = 0.3), Normative Carers (M = 0.3), Conscious Experts (M = 0.2) and Rationalists (M = 0.3) (F(4, 5 2 2) = 3.23, p < 0.05). In their turn, Harmonious Enjoyers (M = 1.9) and Normative Carers (M = 2.1) had a significantly higher consumption of potatoes than did Energetic Experimenters (M = 1.1), Conscious Experts (M = 1.0) and Rationalists (M = 1.3) (F(4, 5 2 2) = 6.81, p < 0.01). Furthermore, Harmonious Enjoyers (M = 2.6) and Normative Carers (M = 2.8) ate significantly more cooked vegetables than did Energetic Experimenters (M = 2.1), Conscious Experts (M = 2.1) and Rationalists (M = 2.2) (F(4, 5 5 2) = 4.17, p < 0.01). 3.3. Reactions toward health advertising ANOVA results revealed significant differences between the five consumer segments regarding their evaluations of targeted F&V health advertising (see Table 4 (Aad) and Table 5 (BI)). When compared to the other segments, Energetic Experimenters had significantly higher Aad (M = 5.7) and BI (M = 5.1) scores for the transformational/self-directed health advertisement (i.e. Ad 2) (F(4, 6 1 1) = 6.93, p < 0.01 for Aad and F(4, 6 1 1) = 8.64, p < 0.01 for BI), whereas Harmonious Enjoyers responded more positively (M = 5.9 for Aad and M = 5.7 for BI) toward the transformational/other-directed advertisement (i.e. Ad 1) (F(4, 6 1 1) = 5.91, p < 0.01 for Aad and F(4, 6 1 1) = 3.84, p < 0.01 for BI). In its turn, the informational/other-directed health advertisement (i.e. Ad 4) appeared to be most appropriate for the Normative Carers as corresponding

487

Aad (M = 6.8) and BI (M = 6.7) measures were significantly higher for the latter segment, compared to the other segments (F(4, 6 1 1) = 21.89, p < 0.01 for Aad and F(4, 6 1 1) = 15.41, p < 0.01 for BI). Finally, findings indicate that the informational/self-directed advertisement (i.e. Ad 3) is more appealing to both the Conscious Experts and the Rationalists as higher Aad (M = 4.7 and 4.6, respectively) and BI (M = 4.5 and 4.5, respectively) scores were detected for these two segments (F(4, 6 1 1) = 4.57, p < 0.01 for Aad and F(4, 6 1 1) = 7.86, p < 0.01 for BI). In addition, for each segment, a comparison was made between the score on Aad and BI for their most appropriate targeted advertisement (see results above) and a general advertisement by means of a Paired Samples T-test (see Table 6). In terms of BI, for all five segments, the most appropriate targeted advertisement elicited a significant higher score compared to the general advertisement (Ad5). With regard to Aad, significant differences between the appropriate targeted advertisement and the general advertisement were only found for three segments. For Conscious Experts and Rationalists, the targeted advertisement did not elicit more positive Aad scores than the more general Ad5. 4. Discussion and conclusions 4.1. Usefulness of health audience segmentation Within this paper a new segmentation scheme has been proposed based on health-related motive orientations

Table 4 Evaluation of health advertisements (Aad)

Transformational/ self-directed ad Transformational/ other-directed ad Informational/ other-directed ad Informational/ self-directed ad **

Cluster 1 (Energetic Experimenters)

Cluster 2 (Harmonious Enjoyers)

Cluster 3 (Normative Carers)

Cluster 4 (Conscious Experts)

Cluster 5 (rationalists)

F

5.72 (1.75)

4.72 (1.69)

4.26 (1.54)

3.65 (1.75)

3.72 (1.63)

6.93**

4.94 (1.77)

5.92 (1.55)

4.37 (1.58)

3.13 (1.62)

3.05 (1.68)

5.91**

5.03 (1.94)

4.65 (1.87)

6.84 (0.94)

4.02 (1.63)

4.12 (1.31)

21.39**

3.99 (1.87)

3.61 (1.94)

4.19 (1.79)

4.73 (1.90)

4.61 (2.10)

4.57**

Cluster 1 (Energetic Experimenters)

Cluster 2 (Harmonious Enjoyers)

Cluster 3 (Normative Carers)

Cluster 4 (Conscious Experts)

Cluster 5 (rationalists)

5.13 (1.84)

4.49 (1.73)

3.85 (1.56)

3.47 (1.74)

3.32 (1.75)

8.64**

4.41 (1.79)

5.74 (1.52)

4.50 (1.54)

3.91 (1.77)

3.96 (1.64)

3.84**

4.12 (1.87)

4.83 (1.98)

6.71 (1.08)

3.99 (1.82)

4.02 (1.93)

15.41**

4.01 (1.50)

3.54 (1.59)

3.27 (1.27)

4.52 (1.50)

4.54 (2.13)

7.86**

p < 0.01.

Table 5 Evaluation of health advertisements (BI)

Transformational/ self-directed ad Transformational/ other-directed ad Informational/ other-directed ad Informational/ self-directed ad **

p < 0.01.

F

488

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

Table 6 Paired samples T-test (general ad vs. motive-related ad) Health segment

Reactions

Consumeroriented Ad

General Ad

P-value (T-test)

Energetic Experimenters

Aad

5.7

4.7

0.001**

BI Aad

5.1 5.9

4.3 4.9

0.000** 0.002**

BI Aad

5.7 6.8

4.3 4.3

0.000** 0.000**

BI Aad

6.7 4.7

4.3 4.5

0.000** n.s.

BI Aad BI

4.5 4.6 4.5

3.9 4.6 3.9

0.010* n.s. 0.030*

Harmonious Enjoyers Normative Carers Conscious Experts Rationalists

n.s. – (not significant). * p < 0.05. ** p < 0.01.

(HRMO) and the usefulness of this segmentation scheme was demonstrated in the process of developing tailored F&V health advertisements. In particular, our segmentation scheme differs from and may add value over traditional sociodemographic or lifestyle segmentation schemes (e.g., Mitchell, 1983) as it comprises a domain-specific segmentation approach based on fundamental motivation variables that influence people’s health behaviors. As such, homogeneity within subgroups is reached at a more fundamental level, i.e., on the basis of explanatory psychological variables that capture people’s reasons/motivations to strive for health instead of descriptive variables, such as sociodemographics or AIO’s, which solely indicate who people are or what they do at a more global level. Greater predictive validity may be expected from such domain-specific motivational variables, as they are more directly linked with the specific behavior under question. Adopting a multidimensional perspective on health, the results of this study provide new insights into the nature of differences in health perception among people. Five consumer segments could be identified within the sample for which health has another distinct meaning. These five segments could be organized along two bipolar dimensions, which represent an intrapersonal (emotional vs. functional) and interpersonal (individualistic vs. altruistic) health perception, respectively. Regarding daily F&V consumption, in this study relatively high levels of F&V intake were obtained. With an average consumption of 5.4 servings per day, our population seems to be in accordance with the international ‘five-a-day’- norm. However, this is unlikely, and surely we must take into account some overestimation of the reported behavior, as self-reported measures concerning ‘healthy’ products (e.g., F&V) – due to a social desirability tendency – are considered to be sensible for ‘overreporting’, whereas self-reported measures concerning ‘unhealthy’ products (e.g., fats and sugars) suffer from

‘underreporting’ (Westerterp & Goris, 2002). Other measures of F&V consumption in Belgium mention lower average values than those that were obtained in our study, with much more people being not in accordance with the recommended levels (Naska et al., 2000; Verbeke & Pieniak, 2006). Another explanation for the high reported levels of F&V intake may be that subjects who decided to participate in our study are more health conscious and/or more involved with F&V consumption, and therefore more likely to eat greater amounts of F&V than the general population of consumers. This is especially likely since the link to the questionnaire was placed within a health rubric on the website of a Flemish newspaper. The fact that the average number of daily servings of F&V did not vary across the five consumer segments might be due to the aforementioned problems of overreporting and sample selection. Another possible explanation may be that differences in health perception among people do not associate with the frequency of daily F&V consumption as such, and thus, that ‘low’ or ‘heavy’ consumers are equally dispersed over all five segments. However, differences might exist among people with different health perceptions regarding the reasons (i.e. motives or barriers) for consuming (or not consuming) a sufficient amount of F&V as different health-related consequences may be beneficial in the context of different health orientations (e.g., ‘having energy’ for Energetic Experimenters, ‘staying slim’ for Conscious Experts, ‘good taste’ for Harmonious Enjoyers, etc.). Though, the latter proposition was not explicitly tested in this study and might be an opportunity for future research. Furthermore, we want to stress that although the segments did not differ a priori in terms of F&V consumption, they did react differently to targeted F&V health advertisements. In particular, all clusters responded more positively (Aad and BI) toward the health advertisement that was designed and expected to be most responsive to their underlying health-related motive orientations, i.e., a transformational/self-directed ad for the Energetic Experimenters (given this segment’s emotional and individualistic health orientation), transformational/other-directed ad for the Harmonious Enjoyers (given this segment’s emotional and altruistic health orientation), informational/ other-directed ad for the Normative Carers (given this segment’s functional and altruistic health orientation) and informational/self-directed ad for the Conscious Experts and Rationalists (given these segments’ functional and individualistic health orientation). Moreover, the segments provided more positive evaluations of the most appropriate targeted advertisement compared to a general advertisement. This further underscores the added value of targeted F&V advertising strategies, and supports the validity of our findings and, hence, the usefulness of our segmentation scheme. If the segments had differed a priori regarding average F&V consumption, it would have been much less straightforward to attribute the observed

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

differences in reactions to the ads to differences in healthrelated motive orientations. In the latter case, the differences in reaction to the ads could have resulted from different levels of involvement with F&V between the clusters. Regarding the differences that exist among the segments with respect to specific types of F&V, we do believe that these differences provide preliminary support of the predictive validity of our proposed segmentation scheme as consumption of different types of F&V, with different characteristics and/or health-related benefits, seems to be important in the context of different health-related motive orientations. For example, the perception of bananas as a source of energy and power may account for the higher consumption of this type of fruit among Energetic Experimenters, whereas potatoes and cooked vegetables may be more preferred by Normative Carers and Harmonious Enjoyers because motive-related associations are made between these types of vegetables and for instance tradition (common dietary habit), caring for the family, family health, and tastefulness. These results may have value for health practitioners and public health authorities as different types of F&V, with different (real or perceived) characteristics and/or health-related consequences, might be positioned in health advertisements directed toward consumers with different health perceptions (e.g., positioning bananas as a source of energy and power to Energetic Experimenters). Hence, members of a particular segment might be persuaded of consuming particular F&V types as an alternative to other consumer goods with the same characteristics (like energy drinks or F&V concentrates for the Energetic Experimenters). The overall aim should be to increase F&V intake overall, through appealing to specific health-related motive orientations of the target audience (e.g. Energetic Experimenters may consume a banana as an alternative to a candy bar). In what follows, some specific suggestions and recommendations are set forth for developing targeted F&V health advertisements for each of the five consumer segments that were identified in the present study. 4.2. Recommendations for targeted promotion of F&V intake 4.2.1. Energetic Experimenters: transformational/selfdirected advertising strategy For members of Segment 1, health advertisements should use a transformational/self-directed advertising strategy, as a rather emotional health orientation is manifest among these people with an individualistic tendency (see Fig. 1). Besides using vivid images that express movement and vitality, we recommend health practitioners to focus on individual consumer experiences such as feeling free, getting energy and power for the body, feeling very much alive and kicking. To increase the perception of being addressed personally, sentences might be put in first-person wording (I-sentences), rather than using removed thirdperson wording.

489

4.2.2. Harmonious Enjoyers: transformational/otherdirected advertising strategy As members of Segment 2 perceive health mainly in terms of emotional well-being, advertisements designed to them should avoid focusing too much on functional aspects of F&V consumption. Rather, we recommend expressing how an increased intake of F&V might be instrumental to achieve a complete and happy life together with family and friends. As for the Energetic Experimenters, a transformational advertising strategy is recommended (e.g. using vivid pictures, informal language, stressing hedonic experiences, etc.). However, for Harmonious Enjoyers, the arguments used in the advertisement should not be self-directed. Rather, other-directed arguments should be employed given these people’s more altruistic health orientation. 4.2.3. Normative Carers: informational/other-directed advertising strategy Given this segment’s functional and altruistic orientation toward health (see Fig. 1), we recommend an informational/other-directed advertising strategy for this particular segment. As Normative Carers are mainly concerned with physical well-being, recommendations in the advertisement should focus in particular on functional benefits of F&V intake such as avoiding illness and health problems. Instead of using vivid images, members of this segment could more effectively be convinced by strong verbal arguments, providing important (healthrelated) information and focusing on the advice and norms of expert-others (doctor, dietician, etc.). In addition, advertisements designed to these people should emphasize the social responsibility aspect that is associated with health. Communicating how F&V may contribute to the preservation of the health of close others (family, children, etc.), might be an appropriate strategy to deal with this issue. 4.2.4. Conscious Experts/ Rationalists: informational/selfdirected advertising strategy In order to counteract these people’s disinterest toward advertising, advertisements designed to them might emphasize one’s own independent capacities to deal with health. Health advertising is likely to be more effective if it makes Conscious Experts/Rationalists feel like natural experts who are capable to keep control over their health by themselves. As a functional and individualistic health orientation is manifest among these people, an informational/self-directed advertising strategy is suggested, with mainly verbal arguments focusing on outward appearance (looking good, looking thin) and showing off competence. 4.3. Limitations and directions for further research This study faces some limitations. Regarding healthrelated motive segmentation, definitely, more research is

490

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

needed to further validate our 45-item scale. Given the conceptual purpose of this study, we feel confident this ‘self-made’ scale performed well to generate six reliable health constructs that served as a solid basis for segmentation. However, from a methodological point of view, additional tests should be performed regarding its psychometric properties (e.g., dimensionality, reliability, etc.). We recommend future studies to concentrate on cross-cultural validity, construct validity and predictive validity, by further testing and examining this scale in multiple countries, for relationships with other concepts (e.g., life values, personality traits, etc.) and within different behavioral contexts. Second, in this study the focus was not set on the strength of health motivation (i.e., low vs. high) as such, but rather on different types of health motives that may exist among individuals. Hence, we did not include an overall health motive/attitude strength measure in our questionnaire, such as e.g., Moorman (1990) health motivation scale, Gould (1988) health consciousness scale or Torabi, Dong-Chul, and Jeng (2004) health attitude scale. However, such measures may be included in future studies about health perception to account for general differences in health attitude strength among consumers from different segments. With respect to actual F&V consumption, caution is warranted when interpreting the results of the Bogers et al. (2004) FFQ. We decided to use this scale as it comprises a standardized measurement instrument, extensively validated by its developers, and developed in the Netherlands, i.e., a country that is rather comparable to Belgium regarding the types or categories of F&V that are commonly available and most frequently consumed. However, this FFQ was developed for epidemiological purposes, i.e., assessing nutrition-health relationships in large groups of subjects, and hence, it might be less well suited for use as an outcome variable or assessment measure of individual consumption patterns as we did in this study. Further, only two aspects of F&V consumption were considered in this study, i.e. consumption frequency and a selection of specific types of F&V that were consumed. Future studies may concentrate on assessing the relationship between health-related motive orientations and other aspects of F&V consumption (e.g., buying process or decision factors) or consumption of other food products with a predominant health image (e.g., seafood or functional foods). In a similar vein, interesting future research opportunities may exist with regard to the relationship between health-related motive orientations and people’s evaluations of F&V health advertisements. In this study only two advertising content dimensions were tested, i.e., message tonality and directionality. Future studies may investigate some other relevant aspects of campaign development and message creation, e.g., different appeals or different types of endorsers.

Regarding the general advertisement that we used in this study, we have to admit that we did not perform a formal manipulation-check on it, which may put into question the truly neutral perception of this stimulus by the respondents. However, we took this advertisement from an existing Belgian F&V health campaign that was designed in a generic manner, and, as such, it differs from the four targeted F&V health advertisements which had a consumeroriented character. Yet in the context of targeted health advertising, the usefulness of the proposed segmentation scheme could be demonstrated in the context of health prevention instead of health promotion. For example, when attempting to develop increasingly successful antismoking or fat reduction advertisements, health communicators may consider the manifest health-related motive orientations of the target audience. Finally, in this study, only perceived effects of targeted health advertising were assessed, as a better performance was only demonstrated with regard to consumer’s selfreported reactions toward health advertisements. In general, far more positive Aad and BI scores were reported for targeted advertisements compared to a general message. The failure to observe significant differences in Aad between the targeted and the general advertisement for Conscious Experts and Rationalists may probably be due to the fact that the latter consumers are less open to and less influenced by advertising (i.e., Aad and BI scores never exceeded the neutral value of 4.5), rather than to a bad performance of the targeted advertisement. Future experimental intervention studies may also investigate actual behavioral effects of targeted health advertising, by assessing the potential effectiveness in increasing real F&V intake. 4.4. General conclusion Using a set of 45 explicit and implicit items referring to people’s subjective perceptions of the meaning of health, this study has identified five consumer segments with distinct health-related motive orientations. Furthermore, this study has demonstrated the practical usefulness of this market segmentation approach in a food consumption and marketing context, more specifically with respect to developing and testing targeted promotion campaigns for stimulating F&V consumption. The findings indicate that a segment’s reactions, in terms of attitude toward the ad and behavioural intention, toward advertising targeted to the segment’s health-related motives are more positive than toward more general advertising. Although the study faces some limitations with mainly related to its scope, these findings entail both substantial opportunities for those who are involved with promoting healthy food choice, as well as particular challenges for future research in this field.

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

Appendix A. Stimuli advertisements Ad 1 (transformational/other-directed)

491

492

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

Ad 2 (transformational/self-directed)

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

Ad 3 (informational/self-directed)

493

494

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

Ad 4 (informational/other-directed)

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

495

Ad 5 (general ad)

Appendix B. List of scale items Health-related Motive Scale Explicit items (Exp) For me, health is mainly about. . . 1. Keeping the body in a good condition, i.e., fitness, jogging, aerobics, etc. 2. Having the energy to do the things I want to do. 3. Taking time to relax and to enjoy life.

4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Living in harmony with my family. Having no physical health problems. Living an active life, i.e., practicing sports, etc. Taking care of other family members’ health. Following the advice of expert-others, i.e., doctor, dietician, etc. Developing a healthy lifestyle of my own. Looking good. Reducing physical health risks with regard to heart, lungs, liver, etc. Staying slim. Emotional well-being, feeling good mentally.

496

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497

14. Keeping up good social contacts. 15. Keeping nutritional intake strictly under control (feeling in control over my body). Implicit items (Imp) Because of health problems, it would be (extremely) bad not to be able anymore to. . . 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

Help others. Feel secure in life. Work functionally. Live an active social life. Behave independently. Be successful. Be classy. Feel protected. Be playful. Work creatively. Get stability in life. Share time with family. Enjoy life. Stay slim. Perceive warmth and conviviality. Stay beautiful. Practice sports. Organize and control life. Be cheerful. Be powerful. Have fun with others. Get rest in life. Have close friends. Be spontaneous. Care for my family. Think rationally. Be ambitious. Be competent. Live an adventurous life. Be stylish.

References Albrecht, T. L., & Bryant, C. (1996). Advances in segmentation modeling for health communication and social marketing campaigns. Journal of Health Communication, 1, 65–80. Bogers, R. P., Van Assema, P., Kester, A. D. M., Westerterp, K. R., & Dagnelie, P. C. (2004). Reproducibility, validity and responsiveness to change of a short questionnaire for measuring fruit and vegetable intake. American Journal of Epidemiology, 159, 900–909. Burke, M. C., & Edell, J. A. (1989). The impact of feelings on ad-based affect and cognitions. Journal of Marketing Research, 26(feb), 69–83. Contento, I. R., Michela, J. L., & Goldberg, C. J. (1988). Food choice among adolescents: Population segmentation by motivations. Journal of Nutrition Education, 20(6), 289–298. Cox, D., Anderson, A., McKellar, S., Reynolds, J., Lean, M., & Mela, D. J. (1996). Vegetables and Fruits: Barriers and opportunities for greater consumption. Nutrition & Food Science, 96(5), 44–47. De Pelsmacker, P., Geuens, M., & Van den Bergh, J. (2007). Marketing communications: A European perspective (3rd ed.). Harlow, England: Pearson Education Limited.

Forthofer, M. S., & Bryant, C. A. (2000). Using audience-segmentation techniques to tailor health behavior change strategies. American Journal of Health behavior, 24(1), 36–43. Freimuth, V., Cole, G., & Kirby, S. (2001). Issues in evaluating mass media health communication campaigns. In I. Rootman, M. Goodstadt, B. Hyndman, D. V. McQueen, L. Potvin, J. Springett, & E. Ziglio (Eds.), Evaluation in health promotion: Principles and perspectives (pp. 475–492). Copenhagen: WHO Regional Office for Europe. French, S. A., & Stables, G. (2003). Environmental interventions to promote vegetable and fruit consumption among youth in school settings. Preventive Medicine, 37, 593–610. Glanz, K., & Yaroch, A. L. (2004). Strategies for increasing fruit and vegetable intake in grocery stores and communities: Policy, pricing and environmental change. Preventive Medicine, 39(Suppl. 2), S75–S80. Gould, S. J. (1988). Consumer attitudes toward health and health care: A differential perspective. Journal of Consumer Affairs, 22, 96–118. Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate data analysis (6th ed.). New Jersey: Pearson Education. Hughner, R. S., & Kleine, S. S. (2004). Views of health in the lay sector: A compilation and review of how individuals think about health. Health, 8(4), 395–422. Jo¨reskog, K., & So¨rbom, D. (1993). Lisrel 8: Structural equation modeling with the SIMPLIS command language. Chicago: SSI Scientific Software International, Inc. Lindholm, L. (1997). Health motives and life values – A study of young persons’ reasons for health. Scandinavian Journal of Caring Sciences, 11(2), 81–89. Mangunkusumo, R. T., Brug, J., de Koning, H. J., van der Lei, J., & Raat, H. (2007). School-based internet-tailored fruit and vegetable education combined with brief counselling increases children’s awareness of intake levels. Public Health Nutrition, 10(3), 273–279. Mitchell, A. (1983). The nine american life styles. New York: Warner. Moorman, C. (1990). The effects of stimulus and consumer characteristics on the utilization of nutrition information. Journal of Consumer Research, 17, 362–374. Naska, A., Vasdekis, V. G. S., Trichopoulou, A., Friel, S., Leonhauser, I. U., Moreiras, O., et al. (2000). Fruit and vegetable availability among ten European countries: How does it compare with the ‘five-a-day’ recommendation?. British Journal of Nutrition 84, 549–556. NIS (2005). Private households statistics. Brussels: NIS, National Institute for Statistics. Ogden, J. (2007). Health psychology (4th ed.). Berkshire: McGraw-Hill Open University Press. Puto, C. P., & Wells, W. D. (1984). Informational and transformational advertising: The differential effects of time. In T. C. Kinnear (Ed.), Advances in consumer research (pp. 638–643). Provo, UT: Association for Consumer Research. Roininen, K., Tuorila, H., Zandstra, E. H., de Graaf, C., Vehkalahti, K., Stubenitsky, K., et al. (2001). Differences in health and taste attitudes and reported behaviour among Finnish, Dutch and British consumers: A cross-national validation of the health and taste attitude scale. Appetite, 37, 33–45. Rossiter, J. R., & Percy, L. (1997). Advertising and promotion management. New York: McGraw-Hill. Schifferstein, H. N. J., & Oude Ophuis, P. A. M. (1998). Health-related determinants of organic food consumption in the Netherlands. Food Quality and Preference, 9(3), 119–133. Slater, M., & Flora, J. (1994). Is health behavior consumer behavior? Health behavior determinants, audience segmentation, and designing media health campaigns. In E. M. Clark, T. C. Brock, & D. W. Stewart (Eds.), Attention, attitude and affect in response to advertising (pp. 273–285). Hillsdale, NJ: Erlbaum. Slater, M. D. (1995). Choosing audience segmentation strategies and methods for health communication. In E. Maibach & R. L. Parrott (Eds.), Designing health messages: Approaches from communication theory and public health practice (pp. 186–198). Thousand Oaks, CA: Sage.

N. Geeroms et al. / Food Quality and Preference 19 (2008) 481–497 Steenkamp, J. B., & Van Trijp, J. C. M. (1991). The use of Lisrel in validating marketing constructs. International Journal of Research in Marketing, 8, 283–299. Steinmetz, K. A., & Potter, J. D. (1996). Vegetables, fruits and cancer prevention. Journal of the American Dietetic Association, 96, 1027–1039. Synovate/Censydiam (2004). Kwalitatief onderzoek inzake gezondheidsbeleving bij de Vlaamse bevolking Unpublished research report. Synovate/Censydiam Institute: Antwerp. Torabi, M. R., Dong-Chul, S., & Jeng, I. (2004). Alternate forms of health attitude scale. American Journal of Health Behavior, 28(2), 166–172. Van Duyn, M. A., & Pivonka, E. (2000). Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: Selected literature. Journal of the American Dietetic Association, 100(12), 1511–1522. Verbeke, W., & Pieniak, Z. (2006). Benefit beliefs, attitudes and behaviour towards fresh vegetable consumption in Poland and Belgium. Acta Alimentaria, 35, 5–16.

497

Verbeke, W. (2005). Agriculture and the food industry in the information age. European Review of Agricultural Economics, 32(3), 347–368. Wang, C. L., & Mowen, J. C. (1997). The separateness-connectedness selfschema: Scale development and application to message construction. Psychology & Marketing, 14(March), 185–207. Weaver, M., Poehlitz, M., & Hutchison, S. (1999). 5 a day for low-income families: Evaluation of an advertising campaign and cooking events. Journal of Nutrition Education, 31(3), 161–169. Westerterp, K. R., & Goris, A. H. C. (2002). Validity of the assessment of dietary intake: Problems of misreporting. Current Opinion in Clinical Nutrition and Metabolic Care, 5, 489–493. WHO (1990). The world health organization report, diet, nutrition and the prevention of chronic diseases. WHO Technical Report Series 797. Zinkhan, G. M., Locander, W. B., & Leigh, J. H. (1986). Dimensional relationships of aided recall and recognition. Journal of Advertising, 15(1), 38–46.