Dairy consumption amongst North Americans aged 30–50 has been declining. Targeted messages have been identified as a cost-efficient method through which to increase health-enhancing behavior, such as dairy intake.
The aim of this study is to assess the utility of targeted, framed, efficacy-enhancing messages on calcium consumption from dairy in adults aged 30–50 in a randomized controlled trial.
Seven hundred and thirty-two individuals (463 women, 269 men; M age = 40.57 years) were randomly assigned to one of five message conditions: (1) gain-framed (GF), (2) loss-framed (LF), (3) self-regulatory efficacy-enhancing (SRE), (4) GF plus SRE (GF + SRE), or (5) LF plus SRE (LF + SRE). Conditions were separate for men and women. Each condition received an emailed message on four consecutive days. Calcium intake from dairy, self-regulatory efficacy, outcome expectations, and outcome value were measured at baseline, 1 and 4 weeks following the intervention.
Calcium intake from dairy significantly increased from baseline to week 1 post-intervention in all conditions (p < .001). A significant message condition x time interaction (p = .04) revealed that increases seen in the LF + SRE condition were maintained at week 4. All social cognitive constructs increased following the intervention (ps < .01). Self-regulatory efficacy (β = .28, p < .01) and outcome expectations (β = .19, p < .01) were significant predictors of subsequent calcium intake (week 4) from dairy.
Taken together, it appears as though ensuring message content is targeted to the specific population’s beliefs and motives is of importance when developing behavioral change intervention material.
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Heaney RP, Layman DK. Amount and type of protein influences bone health. Am J Clin Nutr. 2008; 87: 1567S-1570S.
Wang L, Manson JE, Sesso HD. Calcium intake and risk of cardiovascular disease: A review of prospective studies and randomized clinical trials. Am J Cardiovasc Drugs. 2012; 12: 105-116.
Elwood P, Pickering J, Givens DI, Gallacher JE. The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: An overview of the evidence. Lipids. 2010; 45: 925-939.
Soedamah-Muthu SS, Verberne LDM, Ding EL, Engberink MF, Geleijnse JM. Dairy consumption and incidence of hypertension: A dose–response meta-analysis of prospective cohort studies. Hypertension. 2012; 60: 1131-1137.
Pittas AG, Lau J, Hu F, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007; 92: 2017-1029.
Canadian Dairy Information Centre. Consumption of dairy products. Ottawa, Ontario: Statistics Canada; 2013. Available at http://www.dairyinfo.gc.ca/. Accessibility verified September 21st, 2012.
Statistics Canada. Visual census, age and sex, Canada. 2006 Census. Ottawa, Ontario: Statistic Canada; 2010. Available at https://www12.statcan.gc.ca. Accessibility verified July 28th 2015.
Bailey RL, Dodd KW, Goldman JA, et al. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr. 2010; 140: 817-822.
Jung ME, Stapleton J, Stork MJ, Bourne JE, Martin Ginis KA. A systematic review of interventions aimed at increasing calcium intake in adults: Where do we go from here? Int J of Food Saf Nutr Publ Health. in press.
Estok PJ, Sedlak CA, Doheny MO, Hall R. Structural model for osteoporosis preventing behavior in postmenopausal women. Nurs Res. 2007; 56: 148-158.
Sedlak CA, Doheny MO, Estok PJ, Zeller RA. Tailored interventions to enhance osteoporosis prevention in women. Orthop Nurs. 2005; 24: 270-276.
Rimer BK, Kreuter MW. Advancing tailored health communication: A persuasion and message effects perspective. J Commun. 2006; 56: S184-S201.
Keller PA, Lehmann DR. Designing effective health communications: A meta-analysis. J Public Policy Mark. 2008; 27: 117-130.
Bandura A. Social foundations of thought and action: A social cognitive theory. NJ US: Prentice-Hall, Inc; 1986.
Latimer AE, Rench TA, Rivers SE, et al. Promoting participation in physical activity using framed messages: An application of prospect theory. Brit J Health Psych. 2008; 13: 659-681.
Marmo J. Applying social cognitive theory to develop targeted messages: College students and physical activity. West J Comm. 2013; 77: 444-465.
Eddy KT, Brochetti D, Duncan SE. Older women’s perceptions of dairy foods. J Nutr Elder. 1999; 18: 37-54.
Jung ME, Mistry C, Bourne JE, Perrier MJ, Martin Ginis KA, Latimer-Cheung AE. A qualitative investigation of adults’ perceived benefits, barriers and strategies for consuming milk and milk products. Health Educ J. 2015; 74: 364-378.
Weiglein C, Brochette D, Duncan SE. College-age women’s perceptions of dairy foods. Forum Fam Consum Issues. 2000; 5: 27.
Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science. 1981; 211: 453-458.
Rothman AJ, Salovey P. Shaping perceptions to motivate healthy behavior: The role of message framing. Psychol Bull. 1997; 121: 3-19.
Updegraff JA, Rothman AJ. Health message framing: Moderators, mediators, and mysteries. Soc Personal Psychol Compass. 2013; 7: 668-679.
Gallagher KM, Updegraff JA. (2012). Health message framing effects on attitudes, intentions, and behavior: A meta-analytic review. Ann Behav Med. 2012; 43: 101-116.
Gerend MA, Shepherd MA. (2012). Message framing, it does a body good: Effects of message framing and motivational orientation on young women’s calcium consumption. J Health Psychol. 2012; 18: 1296-1306.
Gutiérrez-Doña B, Lippke S, Renner B, Kwon S, Schwarzer R. Self-efficacy and planning predict dietary behaviors in Costa Rican and South Korean Women: Two moderated mediation analyses. Appl Psychol: Health Well-Being. 2009; 1: 91-104.
Parschau L, Richert J, Koring M, Ernsting A, Lippke S, Schwarzer R. Changes in social-cognitive variables are associated with stage transitions in physical activity. Health Educ Res. 2012; 27: 129-140.
Jung ME, Martin Ginis KA, Phillips SM, Lordon CD. Increasing calcium intake in young women through gain-framed, targeted messages: A randomised controlled trial. Psychol Health. 2011; 26: 531-547.
British Columbia Dairy Foundation. Calcium calculator. Available at http://bcdairy.ca/nutritioneducation/calciumcalculator/. Accessibility verified July 21st, 2012.
Hung A, Hamidi M, Riazantseva E, et al. Validation of a calcium assessment tool in postmenopausal Canadian women. Maturitas. 2011; 69: 168-172.
Bandura A. Self-efficacy: The exercise of control. New York, N.Y.: Freeman; 1997.
McAuley E, Mihalko SL. Measuring exercise-related self-efficacy. In: Duda JL, ed. Advances in sport and exercise psychology measurement. USA: Fitness Information, Inc; 1998: 371-381.
Williams DM, Anderson ES, Winett RA. A review of the outcome expectancy construct in physical activity research. Ann Behav Med. 2005; 29: 70-79.
Tabachnick BG, Fidell LS. Using multivariate statistics. 5th ed. Boston: Allyn and Bacon; 2006.
O’Keefe DJ, Jensen JD. The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease detection behaviors: A meta-analytic review. J Commun. 2009; 59: 296-316.
Rothman AJ, Updergraff JA. Specifying when and how gain- and loss-framed messages motivate behavior: An integrated approach. In: Keren G, ed. Perspectives on Framing. New York: Psychology Press; 2011: 257-278.
O’Keefe DJ, Jensen JD. The relative effectiveness of gain-framed and loss-framed persuasive appeals concerning obesity-related behaviors: Meta-analytic evidence and implications. In: Batra R, Keller PA, Strecher VJ, eds. Leveraging consumer psychology for effective health communications: The obesity challenge. Armonk, NY: M. E. Sharpe; 2011: 171-185.
van Assema P, Marloes M, Robert ACR, Johannes B. Framing of nutrition education messages in persuading consumers of the advantages of a healthy diet. J Hum Nutr Diet. 2001; 14: 435-442.
Kreuter MW, Wray RJ. Tailored and targeted health communication: Strategies for enhancing information relevance. Am J Health Behav. 2003; 27: 227-232.
Conflict of Interest
Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards Authors Jung, Latimer-Cheung, Bourne, and Martin Ginis declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Mary E. Jung, School of Health and Exercise Sciences, University of British Columbia. Amy E. Latimer-Cheung, School of Kinesiology and Health Studies, Queen’s University. Jessica E. Bourne, School of Health and Exercise Sciences, University of British Columbia. Kathleen A. Martin Ginis, Department of Kinesiology, McMaster University.
This research was supported by a grant from the Canadian Agri-Science Clusters Initiative, Dairy Research Cluster (Dairy Farmers of Canada, Agriculture and Agri-Food Canada, and Canadian Dairy Commission). The funders were not involved in the analyses of data or preparation of this manuscript. The views expressed in this publication are those of the authors and not necessarily those of the Dairy Farmers of Canada.
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Jung, M.E., Latimer-Cheung, A.E., Bourne, J.E. et al. Targeted Messages Increase Dairy Consumption in Adults: a Randomized Controlled Trial. ann. behav. med. 51, 57–66 (2017). https://doi.org/10.1007/s12160-016-9828-2
- Calcium consumption
- Behavior change