Whitton Clare, Klug Frith, Bivoltsis Alexia, Trapp Georgina S A, Pulker Claire E
Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia 6845, Australia.
Health Promot Int. 2025 Jul 1;40(4). doi: 10.1093/heapro/daaf128.
Most outdoor food advertising (e.g. billboards and bus stops) features foods that are considered unhealthy. The most important technical challenge when designing policies to restrict unhealthy outdoor food advertising is defining 'unhealthy food'. To date, most restriction policies have used nutrient profiling models (i.e. foods are classified according to their nutritional composition) to determine which foods and beverages may be advertised. In Australia, state governments have endorsed a food category-based classification system, with no prescribed nutrient limits, which may create ambiguity when multiple users are identifying food advertisements to be restricted. This study aimed to assess the consistency of decisions (inter-rater reliability) using a food category-based system to assess outdoor advertisements. Three coders independently assessed outdoor food advertisements (n 550) around 64 schools in metropolitan Perth, Western Australia, using the Council of Australian Governments 'National interim guide to reduce children's exposure to unhealthy food and drink promotion'. Overall, 78.7% of outdoor advertisements were restricted by at least one of three coders and 25.5% by all three; inter-rater reliability was fair [0.29; 95% confidence interval (CI) 0.24, 0.34]. The strongest agreement was for confectionery (κ = 0.94; 95% CI 0.89, 0.99) and desserts, ice cream, and ice confections (κ = 0.99; 95% CI 0.94, 1.04) while the poorest agreement was for brand advertising (κ = 0.04; 95% CI -0.01, 0.09). This study found that the Australian-government-endorsed model could not be consistently applied to assess outdoor food advertising, apart from the narrowly defined categories of confectionery and desserts. Recommendations to reduce ambiguity and policy implications are discussed.
大多数户外食品广告（如广告牌和公交站广告）宣传的都是被认为不健康的食品。在制定限制不健康户外食品广告的政策时，最重要的技术挑战是界定“不健康食品”。迄今为止，大多数限制政策都采用了营养成分剖析模型（即根据食品的营养成分对其进行分类）来确定哪些食品和饮料可以进行广告宣传。在澳大利亚，州政府批准了一种基于食品类别的分类系统，没有规定的营养限制，这可能会在多个用户识别要限制的食品广告时造成歧义。本研究旨在评估使用基于食品类别的系统评估户外广告时决策的一致性（评分者间信度）。三名编码员使用澳大利亚政府理事会的《减少儿童接触不健康食品和饮料促销活动国家临时指南》，对西澳大利亚州珀斯市64所学校周边的户外食品广告（n = 550）进行了独立评估。总体而言，78.7%的户外广告被三名编码员中的至少一人限制，25.5%被三人全部限制；评分者间信度为中等[0.29；95%置信区间（CI）0.24，0.34]。对于糖果（κ = 0.94；95% CI 0.89，0.99）以及甜点、冰淇淋和冰品（κ = 0.99；95% CI 0.94，1.04）的一致性最强，而对于品牌广告的一致性最差（κ = 0.04；95% CI -0.01，0.09）。本研究发现，除了定义狭窄的糖果和甜点类别外，澳大利亚政府批准的模型不能始终如一地用于评估户外食品广告。文中讨论了减少歧义的建议及政策影响。
