Development and Presentation of an Ethical Framework for Health and Medical Apps

The ubiquity of mobile applications makes it difficult to weigh up opportunities and potential risks. One significant aspect of an ethical assessment regarding the development and use of health and medical apps is the lack of clear and consistent guidelines and measures of value. Aim: The aim of this paper was to identify the main ethical determinants associated in the context of health and medical apps and develop a framework for ethical reflection. Methods: A systematic literature search in the database PubMed was undertaken and the journal Biomed Central Medical Ethics was hand searched and 32 met the review criteria. On this basis of the review an interview guide was developed and five purposively selected experts on the field of payers, science, consumers, medical ethics and society were interviewed regarding health and medical apps. Results: There is a lack of consistent and clear guidelines regarding the use of health and medical apps in literature. Indeed, findings refer to established biomedical principles. The interviews identified that several insecurities related to legal and regulatory issues are common. On the other hand, many advantages of the use of health and medical apps have been pointed out by experts. Conclusion: Debates on ethics and the use of health and medical apps should play a significant role in public discussion. Ethical endpoints cannot be considered isolated from each other, and must be regarded as a complex network of aspects connected with each other. Further research should concentrate on the development of consistent guidelines and a framework for reflection of occurring ethical concerns

Evoked Emotions Predict Food Choice

In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA) and apply Multinomial Logit Models (MLM) to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively). After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products) for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores

Food color is in the eye of the beholder: the role of human trichromatic vision in food evaluation

Non-human primates evaluate food quality based on brightness of red and green shades of color, with red signaling higher energy or greater protein content in fruits and leafs. Despite the strong association between food and other sensory modalities, humans, too, estimate critical food features, such as calorie content, from vision. Previous research primarily focused on the effects of color on taste/flavor identification and intensity judgments. However, whether evaluation of perceived calorie content and arousal in humans are biased by color has received comparatively less attention. In this study we showed that color content of food images predicts arousal and perceived calorie content reported when viewing food even when confounding variables were controlled for. Specifically, arousal positively co-varied with red-brightness, while green-brightness was negatively associated with arousal and perceived calorie content. This result holds for a large array of food comprising of natural food - where color likely predicts calorie content - and of transformed food where, instead, color is poorly diagnostic of energy content. Importantly, this pattern does not emerged with nonfood items. We conclude that in humans visual inspection of food is central to its evaluation and seems to partially engage the same basic system as non-human primates

Brain Potentials Highlight Stronger Implicit Food Memory for Taste than Health and Context Associations

Increasingly consumption of healthy foods is advised to improve population health. Reasons people give for choosing one food over another suggest that non-sensory features like health aspects are appreciated as of lower importance than taste. However, many food choices are made in the absence of the actual perception of a food's sensory properties, and therefore highly rely on previous experiences of similar consumptions stored in memory. In this study we assessed the differential strength of food associations implicitly stored in memory, using an associative priming paradigm. Participants (N = 30) were exposed to a forced-choice picture-categorization task, in which the food or non-food target images were primed with either non-sensory or sensory related words. We observed a smaller N400 amplitude at the parietal electrodes when categorizing food as compared to non-food images. While this effect was enhanced by the presentation of a food-related word prime during food trials, the primes had no effect in the non-food trials. More specifically, we found that sensory associations are stronger implicitly represented in memory as compared to non-sensory associations. Thus, this study highlights the neuronal mechanisms underlying previous observations that sensory associations are important features of food memory, and therefore a primary motive in food choice.</p

Affective and cognitive drivers of food choice

Abstract Introduction In sensory science liking ratings are commonly used to understand and predict food intake and choice. And indeed, higher liked products are more often chosen than lower liked products. However, there is more to food choice than sensory liking per se, as many highly liked products fail on the market. A broader perspective on how consumers experience a food product is needed, where we take into account that individuals experience and attach emotions and cognitive associations to foods. Measuring these, in addition to liking, might explain and predict food choice better. Aim The aim of this thesis was to test if food-evoked emotional and cognitive associations explain and predict food choice better than sensory liking per se. Hereby we focused on the sensory and packaging product properties. In addition, we investigated the link between sensory properties and emotional responses to foods; and the influence of the context appropriateness on choice. Methods We conducted a series of product profiling experiments of test products (breakfast drinks) with regular consumers. Participants rated emotional responses and liking to a set of tasted test products, and subsequently, after an interval of one week, participants’ actual choice was observed, after again tasting the series of product samples (presented blind) to choose from. In the following study we took the same measures, but now included the products packaging. Thus, participants rated emotional responses also to the product’s package and they chose one product after viewing the packages of all test products (without tasting). Two dessert products were included in the product set to assess the impact of eating occasion appropriateness. The test products were also evaluated by a trained panel on sensory characteristics using descriptive analysis. In the last study, we assessed cognitive terms (emotional and functional words) participants associate with sensory attributes and the products’ package. And, participants rated liking and chose, after an interval of one week, a product based on the products’ packages. Results The measured emotional responses could be decomposed in two dimensions, i.e. valence (pleasant to unpleasant) vs. arousal (calm to excitement). The combination of emotion valence and liking scores predicted individual choice based on the products taste for over 50% of all participants and was a better predictor of choice than liking scores alone. The combination of liking, valence and also arousal resulted in the best prediction for package-based choice with correct predicted individual choices for 41% of all participants. Furthermore, we demonstrated that the match, between the cognitive associations to the products sensory and packaging cues, was positively related to choice. However, liking ratings outperformed the product-package-match in predicting individual product choice. In particular, expected liking (based on the product’s package) predicted 25% more individual choices correct than the product-package-match. Furthermore, we demonstrated that a product was more likely to be chosen when the package provided context appropriate information (i.e. breakfast context for breakfast drinks). Lastly, we found that texture-related attributes were drivers of positive emotions and that specific taste-related attributes were drivers of specific arousal emotions. Conclusion Emotional and cognitive responses to foods are relevant drivers of choice behaviour. Food-evoked emotional responses predicted choice consistently better than liking scores alone. However, the combination of liking scores and emotions was the best predictor of food choice based on the product’s taste and packaging. Hence, emotions may explain and guide consumers’ choice behaviour. Furthermore, product profiles, based on cognitive product associations, seem to be related to choice behaviour; but it is still unclear what their contribution is in predicting choice based on liking per se. In addition, it was shown that appropriateness also influences package-based choice. Lastly, links between sensory and emotional profiling were identified which offer a possible application of the findings on food-evoked emotions in product development

Affective and cognitive drivers of food choice

<strong>Abstract</strong> <strong>&nbsp;</strong><strong>Introduction</strong> In sensory science liking ratings are commonly used to understand and predict food intake and choice. And indeed, higher liked products are more often chosen than lower liked products. However, there is more to food choice than sensory liking per se, as many highly liked products fail on the market. A broader perspective on how consumers experience a food product is needed, where we take into account that individuals experience and attach emotions and cognitive associations to foods. Measuring these, in addition to liking, might explain and predict food choice better. <strong>Aim</strong> The aim of this thesis was to test if food-evoked emotional and cognitive associations explain and predict food choice better than sensory liking per se. Hereby we focused on the sensory and packaging product properties. In addition, we investigated the link between sensory properties and emotional responses to foods; and the influence of the context appropriateness on choice. <strong>&nbsp;</strong><strong>Methods</strong> We conducted a series of product profiling experiments of test products (breakfast drinks) with regular consumers. Participants rated emotional responses and liking to a set of tasted test products, and subsequently, after an interval of one week, participants&rsquo; actual choice was observed, after again tasting the series of product samples (presented blind) to choose from. In the following study we took the same measures, but now included the products packaging. Thus, participants rated emotional responses also to the product&rsquo;s package and they chose one product after viewing the packages of all test products (without tasting). Two dessert products were included in the product set to assess the impact of eating occasion appropriateness. The test products were also evaluated by a trained panel on sensory characteristics using descriptive analysis. In the last study, we assessed cognitive terms (emotional and functional words) participants associate with sensory attributes and the products&rsquo; package. And, participants rated liking and chose, after an interval of one week, a product based on the products&rsquo; packages. <strong>&nbsp;</strong><strong>Results</strong> The measured emotional responses could be decomposed in two dimensions, i.e. valence (pleasant to unpleasant) vs. arousal (calm to excitement). The combination of emotion valence and liking scores predicted individual choice based on the products taste for over 50% of all participants and was a better predictor of choice than liking scores alone. The combination of liking, valence and also arousal resulted in the best prediction for package-based choice with correct predicted individual choices for 41% of all participants. Furthermore, we demonstrated that the match, between the cognitive associations to the products sensory and packaging cues, was positively related to choice. However, liking ratings outperformed the product-package-match in predicting individual product choice. In particular, expected liking (based on the product&rsquo;s package) predicted 25% more individual choices correct than the product-package-match. Furthermore, we demonstrated that a product was more likely to be chosen when the package provided context appropriate information (i.e. breakfast context for breakfast drinks). Lastly, we found that texture-related attributes were drivers of positive emotions and that specific taste-related attributes were drivers of specific arousal emotions. <strong>&nbsp;</strong><strong>Conclusion</strong> Emotional and cognitive responses to foods are relevant drivers of choice behaviour. Food-evoked emotional responses predicted choice consistently better than liking scores alone. However, the combination of liking scores and emotions was the best predictor of food choice based on the product&rsquo;s taste and packaging. Hence, emotions may explain and guide consumers&rsquo; choice behaviour. Furthermore, product profiles, based on cognitive product associations, seem to be related to choice behaviour; but it is still unclear what their contribution is in predicting choice based on liking per se. In addition, it was shown that appropriateness also influences package-based choice. Lastly, links between sensory and emotional profiling were identified which offer a possible application of the findings on food-evoked emotions in product development

High satiety expectations of a first course promote selection of less energy in a main course picture task

One of the factors determining meal size is the expectation one has about satiating properties of foods. Foods eliciting low satiety expectations are often chosen in larger portions. We investigated whether satiety expectations of one food lead to a different portion size selection of other foods, using an online picture task. One hundred and twenty-six subjects (64 unrestrained, 62 restrained) participated in three conditions (within-subject). In two conditions subjects were asked to imagine they consumed soup as a first course. They were shown pictures of soups differing in terms of visual attributes, e.g. colour intensity, ingredients variety, etc. that conveyed a high or low expected satiety. In the control condition, no picture was shown. After viewing either a soup picture or no picture, subjects chose an ideal menu and portion size out of several other foods (meat, side dishes and vegetables) via an online choice task, specifically developed for this experiment. The energy (kcal) and weight (grams) selected for the main course was measured. More energy was chosen in the low satiety compared with the high satiety soup picture condition, but this effect was only significant for restrained eaters. This study shows that satiety expectations of a first course 'carry over' to the rest of the menu in people who carefully watch their diet, i.e. restrained eaters make satiety estimations for an entire menu. Our online choice task was able to capture these estimations in an implicit manner

Food choice: The battle between package, taste and consumption situation

The present study compared how intrinsic (sensory) and extrinsic (packaging) product properties influence actual food choice in combination with the concept of product appropriateness in a specific consumption context. Food choice of seven test products was measured in three breakfast sessions within a simulated cafeteria setting with subsequent product consumption. Test products were five breakfast drinks and two dessert products considered as inappropriate for breakfast. One hundred and three participants took part in a blind taste session, after which they chose one out of the seven foods to consume for breakfast. In a second session (familiar package session), the same participants based their choice on the package of the seven foods they tasted in the first session. An additional group of 65 participants took part in a third naïve package session, where they chose just on the basis of package without being previously exposed to the foods. Results showed that food choices in the naïve package session were guided by the package that labelled the products as “breakfast product”. Food choices in the blind session were strongly correlated (r¿=¿0.8) with the liking of the products. Food choice in the “familiar package session” lay between the blind and naïve package session. It is concluded that food choice in a simulated cafeteria setting is guided by extrinsic (package) as well as intrinsic (sensory) properties and both can act as a cue for product appropriateness given a specific consumption context. Depending on the salience of either intrinsic or extrinsic properties during the choice moment their impact on choice is stronger

Mode Choice Effects on Bike Sharing Systems

Bike-sharing systems (BSS) are offered in many cities and urban municipalities and urban areas without such systems are thinking about their introduction. In addition, many studies on BSS are available; however, neither mode nor route choice parameters are available for station-based BSS, which are required for the implementation of BSS in local and regional transport demand models. As a result, this makes it impossible to simulate demand model-based effects of these systems on other transport modes and e.g., calculate scenario-guided modal shifts. The paper presents results obtained from a survey study, which aims to estimate BSS-related choice parameters. The study combined computer-assisted telephone interviews (CATI) for a collection of revealed preferences (RP) on the use of BSS with a follow-up paper-and-pencil survey on stated preferences (SP) of 220 BSS users and non-users from the Rhine-Neckar area in mid-west Germany. Considering the three transport modes BSS, public transport (PT), and private motorized transport (PMT), results from this choice experiment and, according to behavioural parameters, allow integration of BSS in transport demand models and a simulation of modal shifts. Survey design, mode-choice experiment, and choice models are presented in this paper

What reported food-evoked emotions may add: A model to predict consumer food choice

Food-evoked emotions provide information that goes beyond the information from traditional hedonic ratings. The objectives of our study were: (i) to investigate how intrinsic (sensory) and extrinsic (packaging) cues affect consumers’ emotional responses to foods, and (ii) to explore whether emotional responses to these cues combined with liking, predict actual food choice. Participants (n = 103) rated emotional responses to seven products under a blind taste, a package and a package and taste condition using the EsSense Profile™. During the blind taste condition participants also scored liking of the products. Test products were breakfast drinks and desserts. Food choice was measured in two different breakfast sessions reflecting a different choice context. In one choice context, products were presented blind to taste, after which participants chose one out of the seven foods to consume for breakfast. In the other choice context, participants based their choice on the package of the seven foods without tasting them. Results showed that emotions evoked by food products could be organised in a two-dimensional space, representing a valence (pleasantness) and an activation/arousal dimension. Specific emotional profiles generated for products differed across the blind taste, package and the package and taste condition, meaning that intrinsic and extrinsic product properties elicit in part different emotions. Liking and valence together had the strongest predictive value for product choice based on the product’s taste. The combination of liking, valence and arousal had the strongest predictive value for package-based choice. In conclusion, food-evoked emotions add predictive value to solely liking ratings, and may guide consumers’ product choice behaviour