studies on PACE Flashcards
iris et al., 2023- intervention study
Decided to put labels on food in schools: PACE labelling on cakes and biscuits in secondary schools.
- Schools randomised into control (n=6) or intervention (n=7)
- Primary outcome measure: number of weekly purchases sold of cakes and biscuits
- Anonymised purchasing used as proxy outcome for consumption as most individuals would consume their purchase
- Intervention schools displayed PACE labelling for a minimum of 4 weeks and for up to 6 weeks
- Control Schools or continued with usual practice
- Anonymised purchase data from schools on number cakes/sweet biscuits sold, before, during and after the study period collected
Schools:
- Ranged in size (from 709 to 1781 students)
- Located in urban (n=8) and rural areas (n=3)
- From the East and West Midlands and the North-East regions of England
- Based in affluent and deprived areas as defined by % pupils eligible for free school meals within schools (ranged from 10% to 42%)
Before intervention, number of sales between schools varied. School G – sale increased. Could depend on the time of year it was done. Baseline = when schools started in September or January
Interventions were stopped over half terms.
Analysis showed small but significant amount of decrease in purchase of cakes in the intervention school.
Sent out letters to schools in intervention group – asked questions and asked them to expand on their responses.
Most people found it helpful or extremely helpful – small amount
qualitative interviews-
Findings from interviews shows PACE labelling appears to:
- Increase capability in young people’s food decision making
- Influence them to avoid/reduce purchases of cakes and biscuits as they associated eating them with ‘high energy cost’.
- Be a useful approach to help young people choose healthier food in the school environment
Qualitative interviews:
Mixed Findings – depends on the individuals’ own attitude, viewpoints and motivation
- Qualitative quotes found answers depended on individuals own attitudes, motivation and opinions towards their eating.
- Eg: people that weren’t bothered about changing eating behaviours found labels unhelpful – those aware of their health changed their eating behaviours.
- Not one ppt did the full amount of episode.
Some schools pulled out – had to have permission from parents. Out of 12/13 schools, 2 pulled out due to parents being unhappy about the impact that it would have.
Therefore, asked students what they thought about being exposed to the knowledge^^
iris et al., conculsion
- Initial survey studied 808 young people recruited from different secondary schools which involved showing students TLL and pace labels.
o 96% said they had previously seen TLLs on food and drinks.
o PACE labels were reported easier to understand compared to TLL (69% vs 31%).
o 52% felt PACE labels were easier to help choose healthy food and drinks on their own compared to the TLL. - Then, did an intervention study involving PACE labels being put on cakes and biscuits in 13 secondary schools (2 dropped out due to controversy). The amount of weekly purchases made on cakes and biscuits were measured in both the control and intervention groups. They were on display for between 4 to 6 weeks.
- It was found that there was a small decrease in the purchases of cakes and biscuits in intervention schools which was statistically significant. Around 11 less cakes and biscuits were bought per 100 in intervention schools compared to control schools.
- Downside - sales may have differed on time of the year (after Christmas = less) and interventions were stopped during half terms.
- When letters were sent out asking children if this was helpful - only a small amount said not helpful.
- It was found from qualitative interviews that the extent to which this helped individuals depended on their viewpoints. For example, those who weren’t bothered about changing their eating habits didn’t whereas those who were did. Also, depends on emotional experience, some people felt happier choosing lower calorie options whereas for some it was triggering experiences of guilt.
- Findings suggested that this increases the capability to make decisions for food and reduce the chances of buying cakes and biscuits. This could be helpful yet controversial for helping make healthier food choices in schools.
Burney and Irwin 1999- feeling of guilt when eating is a risk associated with eating disorders, including anorexia- acknowledging the findings in the qualitative interviews is therefore important
Theory of planned behaviour
The Theory of Planned Behavior (TPB) (Azjen et al., 2011) can help explain how PACE labeling influences the consumption of energy-dense foods by targeting attitudes, subjective norms, and perceived behavioral control. PACE labels may shift attitudes by highlighting the physical activity required to burn off calories, making energy-dense foods less appealing. They can also leverage subjective norms by aligning healthy eating with societal values and peer influence, encouraging individuals to make healthier choices. Additionally, PACE labels enhance perceived behavioral control by providing clear, actionable information, although access to healthier alternatives is crucial to support these choices. Findings from Sarintohe et al. (2023) support the role of TPB components in influencing food intentions. Their study showed that attitudes and subjective norms were positively associated with short-term (next-day) and long-term (next-week) intentions to consume energy-dense foods, with attitudes being stronger predictors for immediate decisions. Descriptive norms, however, were more influential in long-term intentions, highlighting the importance of social influences over time. By shaping intentions through these components and addressing barriers like cost and convenience, PACE labeling, paired with strategies to align cultural and social norms, can promote healthier eating habits and reduce the intake of energy-dense foods
