"Examining Marketing and Parents’ Perceptions of Toddler Milk”

摘要 幼儿奶（即，一种超加工的牛奶饮料，销售给幼儿）在美国越来越受欢迎 和全球范围内。然而，医学和儿科协会不推荐幼儿奶，因为它 通常含有添加糖，早期食用添加糖与肥胖和2型糖尿病有关。 糖尿病幼儿牛奶包装包含包装前（FOP）声称营销所谓的“好处”， 该产品.此类营销声明不受美国食品药品监督管理局（FDA）的监管， 误导父母关于幼儿牛奶的健康性。在理解如何做到这一点方面存在着巨大的差距。 幼儿奶包装上的营销元素影响父母对产品的看法和信念。 这一差距代表了一个关键的公共卫生问题，因为了解营销如何声称对幼儿 牛奶包装影响父母是必要的，以告知标签政策，并防止父母接触到 没有科学依据的信息。这个项目研究了幼儿奶粉营销如何影响 父母的看法和信念，通过系统的审查，包装内容分析，和焦点小组， 父母利用一级和二级数据，本研究旨在：1）描述幼儿牛奶的决定因素 购买和营销对父母的信念和行为的影响进行了系统的审查。 在这一目标下，系统综述和荟萃分析的首选报告项目指南 （PRISMA）声明将被使用，并将综合现有的关于幼儿奶标签的文献; 2） 描述美国前5大幼儿奶品牌的营养品质和FOP营销声明 通过对幼儿奶FOP标签进行含量分析，对22个拉丁美洲国家进行了研究。这一目标将 阐明和量化食品公司围绕幼儿奶的标签营销做法;以及3）探索如何 营销曝光，包括对FOP声明和警告的反应，影响父母的看法，信念， 和使用幼儿奶。焦点小组与幼儿的父母将提供深入的知识， 为什么目标2中确定的营销实践会影响父母的看法和信念。整体训练 目标是从理论上理解营销实践如何影响消费者的消费行为。 认知和信念，同时培养进行系统审查，内容分析和焦点小组的技能 数据分析这项拟议中的研究符合NICHD "提高儿童生活质量"的使命，也是及时的 而且意义重大，因为它将使人们了解食品标签如何影响父母， 支持食品标签政策变化的证据。最终，这些知识有可能告知FDA 这样它就可以规范幼儿牛奶的包装，保护父母不给孩子喂不健康的产品， 在发展的关键阶段。

ABSTRACT Toddler milk (i.e., an ultra-processed milk-based drink marketed to toddlers) is increasing in popularity in the US and globally. However, toddler milk is not recommended by medical and pediatric associations, because it usually contains added sugar, and early consumption of added sugar is associated with obesity and type 2 diabetes. Toddler milk packaging contains front-of-package (FOP) claims marketing the supposed “benefits” of the product. Such marketing claims are not regulated by the Food and Drug Administration (FDA) and may mislead parents about the healthfulness of toddler milk. There is a significant gap in understanding how marketing elements on toddler milk packaging influence parents' perceptions of and beliefs about the product. This gap represents a critical public health problem because understanding how marketing claims on toddler milk packages affect parents is necessary to inform labeling policy and prevent parents from exposure to information that is not supported by science. This project examines how toddler milk marketing influences parental perceptions and beliefs via a systematic review, packaging content analysis, and focus groups with parents. Using primary and secondary data, this study aims to: 1) Describe the determinants of toddler milk purchasing and the influence of marketing on parents’ beliefs and behavior by conducting a systematic review. Under this aim, the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement will be used, and the existing literature around toddler milk labeling will be synthesized; 2) Describe the nutritional qualities and FOP marketing claims of the top 5 toddler milk brands in the United States and 22 Latin American countries by conducting a content analysis of toddler milk FOP labels. This aim will elucidate and quantify food companies' labeling marketing practices around toddler milk; and 3) Explore how marketing exposure, including reactions to FOP claims and warnings, influences parents' perceptions, beliefs, and use of toddler milk. Focus groups with parents of toddlers will provide in-depth knowledge about how and why the marketing practices identified in Aim 2 affect parents' perceptions and beliefs. The overall training objectives are to develop a theoretical understanding of how marketing practices influence consumers' perceptions and beliefs while developing skills to conduct systematic reviews, content analysis, and focus group data analysis. The proposed research fits with NICHD's mission of “enhancing the lives of children,” and is timely and significant because it will generate both an understanding of how food labeling influences parents and evidence to support food labeling policy change. Ultimately, such knowledge has the potential to inform the FDA so that it can regulate toddler milk packaging and protect parents from feeding their children an unhealthy product during a crucial phase of development.