Clustering of attitudes towards obesity: a mixed methods study of Australian parents and children

Abstract

BackgroundCurrent population-based anti-obesity campaigns often target individuals based on either weight or socio-demographic characteristics, and give a ‘mass’ message about personal responsibility. There is a recognition that attempts to influence attitudes and opinions may be more effective if they resonate with the beliefs that different groups have about the causes of, and solutions for, obesity. Limited research has explored how attitudinal factors may inform the development of both upstream and downstream social marketing initiatives.MethodsComputer-assisted face-to-face interviews were conducted with 159 parents and 184 of their children (aged 9–18 years old) in two Australian states. A mixed methods approach was used to assess attitudes towards obesity, and elucidate why different groups held various attitudes towards obesity. Participants were quantitatively assessed on eight dimensions relating to the severity and extent, causes and responsibility, possible remedies, and messaging strategies. Cluster analysis was used to determine attitudinal clusters. Participants were also able to qualify each answer. Qualitative responses were analysed both within and across attitudinal clusters using a constant comparative method.ResultsThree clusters were identified. Concerned Internalisers (27% of the sample) judged that obesity was a serious health problem, that Australia had among the highest levels of obesity in the world and that prevalence was rapidly increasing. They situated the causes and remedies for the obesity crisis in individual choices. Concerned Externalisers (38% of the sample) held similar views about the severity and extent of the obesity crisis. However, they saw responsibility and remedies as a societal rather than an individual issue. The final cluster, the Moderates, which contained significantly more children and males, believed that obesity was not such an important public health issue, and judged the extent of obesity to be less extreme than the other clusters.ConclusionAttitudinal clusters provide new information and insights which may be useful in tailoring anti-obesity social marketing initiatives.

Should support for obesity interventions or perceptions of their perceived effectiveness shape policy?

“…To examine heterogeneity among respondents' support we used the SPSS K‐Means routine and followed Olds et al's approach, 5 to produce three intervention support segments. Because Old et al's research involved both adults and children and we surveyed only adults, we did not expect the two studies to have identical findings; nevertheless, the two segmentation solutions are quite similar 5 …”

“…Recommended approaches range from more extensive and intensive education programs to policy interventions that re‐shape consumers' social and choice environments. These suggestions reflect a wider debate over the desirability and effectiveness of ‘up‐stream’ (policy‐oriented and environmentally‐focused) and ‘down‐stream’ (education‐oriented and individually‐focused) interventions 5–8 …”

“…Many polls report that the public see poor decision making as causing obesity and view the solution as more education and personal responsibility, 7,9–13 a stance supported by the food industry. Some studies report respondents see the widespread availability of unhealthy foods as causing obesity, but most find that a majority holds individuals themselves (or parents) responsible for addressing obesity 4,5,9–12,14–17 …”

Indonesian healthy living intentions: Segmentation study insights

“…Social marketing program designers have begun to apply segmentation theory to understand group differences in study populations in diverse fields including obesity (McLeay & Oglethorpe, ; Olds, Thomas, Lewis, & Petkov, ), alcohol (Dietrich, Rundle‐Thiele, Leo et al, ; Dietrich, Rundle‐Thiele, Schuster et al, ), and physical activity (Rundle‐Thiele, Kubacki, Tkaczynski, & Parkinson, ). Segmentation has been considered as a key ingredient for designing more targeted social marketing programs (Andreasen, ; Lefebvre & Flora, ; Rundle‐Thiele et al, ).…”

A conceptual classification of parents’ attributions of the role of food advertising in children’s diets

“…To optimize its effectiveness, such an approach requires an understanding of the extent to which different segments of parents attribute their children's weight outcomes to their own actions or those of external forces. Little is known about segment variation in terms of causal attributions, as many of the relevant studies to date have provided aggregated data relating to parents' attitudes to food marketing to children [37,38,42], considered perceptions of causes of obesity in general rather than child obesity [43,44], or focused on the food-related attitudes and behaviors of disadvantaged groups [45,46]. As outlined below, the present study utilized an exploratory approach to generate data about Australian parents' attributions regarding their children's diets and the role of food promotion, with a segmentation approach used to provide insight into the varying perspectives of different groups of parents.…”