title: Using aversive images to enhance healthy food choices and implicit attitudes: An experimental test of evaluative conditioning.
abstract: OBJECTIVE
  To examine the effect of communicating images of energy-dense snack foods paired with aversive images of the potential health consequences of unhealthy eating, on implicit and explicit attitudes and food choice behavior.
  
  
  METHODS
  Participants were randomly allocated to either an evaluative conditioning (EC) procedure that paired images of snack foods with images of potential adverse health consequences or a control condition that featured images of snack foods alone.
  
  
  METHODS
  Implicit attitudes were assessed pre- and post-intervention. Explicit attitudes and food choice behavior were assessed post-intervention.
  
  
  RESULTS
  The conditioning intervention made implicit attitudes toward energy-dense snacks more negative, with this effect greatest in those with relatively more favorable implicit attitudes toward these snacks at baseline. Participants in the conditioning intervention were more likely to choose fruit rather than snacks in a behavioral choice task, a relationship mediated by changes in implicit attitudes.
  
  
  CONCLUSIONS
  Presenting aversive images of potential health consequences with those of specific foodstuffs can change implicit attitudes, which impacts on subsequent food choice behavior.
authors.affiliation: Health Psychology Section, Department of Psychology, King’s College London, London, UK. gareth.hollands@kcl.ac.uk
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Hollands
authors.forename: Andrew
authors.initials: A
authors.lastname: Prestwich
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Marteau
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D010781:Photography; D055815:Young Adult