title: Emolabeling increases healthy food choices among grade school children in a structured grocery aisle setting.
abstract: Health literacy, the ability to acquire health-related knowledge and make appropriate health-related decisions, is regarded as a key barrier to meaningfully convey health information to children and can impact food choice. Emolabeling is an image-based labeling strategy aimed at addressing this problem by conveying health information using emotional correlates of health using emoticons (happy = healthy; sad = not healthy). To test the utility of such a method to promote healthy food choices among children, 64 children (59% girls, <5% non-White, mean BMI = 52nd percentile) in kindergarten through 5th grade were first given a brief 5-min lesson on how to use the emoticons, then asked to choose any 4 foods in each of 2 aisles structured to mimic a grocery aisle - there were 12 identical foods placed in the same location in each aisle with half being low calorie and half high calorie snacks. Foods were emolabeled in one aisle; no emolabels were used in the other aisle; the order that children were brought in each aisle was counterbalanced. Results showed that adding emolabels increased the number (M ± SD) of healthy foods chosen (3.6 ± 0.7 with vs. 2.3 ± 1.1 without emolabels present [95% CI 1.0, 1.5], R(2) = .67) and reduced the total calories (M ± SD) of foods chosen (193.5 ± 88.5 Cal with vs. 374.3 ± 152.6 Cal without emolabels present [95% CI -212.6, -149.0], R(2) = .70). Hence, adding emolabels was associated with healthier food choices among children, thereby demonstrating one possible strategy to effectively overcome health literacy barriers at these ages.
authors.affiliation: Department of Psychology, St. Bonaventure University, St. Bonaventure, NY, USA. Electronic address: gprivite@sbu.edu.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Privitera
authors.affiliation: Department of Education, Duquesne University, Pittsburgh, PA, USA.
authors.forename: Taylor E
authors.initials: TE
authors.lastname: Phillips
authors.affiliation: Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA.
authors.forename: Faris M
authors.initials: FM
authors.lastname: Zuraikat
authors.affiliation: Honors College, George Mason University, Fairfax, VA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Paque
mesh_terms: D002359:Cartoons as Topic; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D002755:Choice Behavior; D004038:Diet, Reducing; D057140:Fast Foods / Q000009:adverse effects / Q000191:economics; D005260:Female; D005515:Food Labeling; D057141:Food, Preserved / Q000009:adverse effects* / Q000191:economics; D006266:Health Education; D057220:Health Literacy; D006801:Humans; D008297:Male; D009518:New York; D018673:Nutrition Policy; D010349:Patient Compliance; D063766:Pediatric Obesity / Q000209:etiology / Q000517:prevention & control*; D012574:Schools; D062410:Snacks
keywords: Childhood; Emolabeling; Emoticons; Food choice; Health; Literacy