Optimizing the possession portfolio.

Most consumers live surrounded by physical goods, some of which are used often and others that are largely neglected. In this article, we introduce the concept of a "possession portfolio" which we define as an individual's holistic sense (vs. an objective listing) of the totality of the physical goods they own at a given point in time. We propose that there is an optimal possession portfolio for each individual where they feel they have achieved balance between the benefits of retaining the "right" number and type of possessions without incurring the downsides of disposing of too many possessions. In doing so, we highlight recent research relevant to the value assessment process that underlies the retention and disposition decisions made when individuals attempt to optimize their possession portfolio.

Identifying meaningful dietary intake and physical activity questions for individual and population health.

We aimed to identify valid screening questions for adults regarding physical activity and dietary behaviours that (a) were correlated with BMI, (b) were deemed by patients and providers to be relevant to clinical care, and (c) have utility for longitudinal understanding of health behaviours in populations. The goal was to identify screening questions that could be implemented at annual health care visits. First, we identified dietary behaviour questions and solicited patient input. Next, we tested both physical activity and dietary behaviour questions in a large sample to test their potential utility. Finally, we used cognitive interviews with patients and physicians to narrow our assessment for clinical settings. We present a parsimonious and reliable six-question scale of physical activity and dietary behaviours for research settings, as well as a three-question scale for clinical settings. We demonstrate a robust relationship between these measures and obesity. Additionally, we present evidence that these measures may serve as a useful red flag for patients before they develop obesity. We provide a concise and useful tool for assessing patients' physical activity and dietary behaviours in a variety of research settings. We also highlight the importance of incorporating this tool into the clinical intake flow for inclusion in patients' Electronic Health Record.

The messy satiation effect: Understanding how eating messily can accelerate the rate of satiation and reduce consumption.

The visual presentation of food plays an important role in shaping the food choices that consumers make. In the current research, we explore the impact that one's eating manner, and by extension, how messy or neat food becomes as a result, can have on enjoyment and consumption over the course of an eating episode. In a series of five studies, we find that eating in a messy manner, which degrades the visual appeal of one's food, can accelerate the rate of satiation and decrease consumption, a phenomenon we term the messy satiation effect. This effect occurs because the disgust response induced by the visual degradation of a food's presentation decreases tastiness perceptions. Accordingly, we position the messy satiation effect as a simple intervention that can be used in some circumstances to combat overconsumption and therefore increase healthier eating patterns through reducing intake, thus providing contributions to both theory and practice.

Development of Brief Child Nutrition and Physical Activity Screening Questions for Electronic Health Record Use.

Background: To develop and test brief nutrition and physical activity screening questions for children ages 2-11 years that could be used as a pragmatic screening tool to tailor counseling, track behavior change, and improve population health. Methods: A literature review identified existing validated questions for nutrition and physical activity behaviors in children ages 2-11 years. Response variation and concurrent validity was then assessed using a mechanical Turk (MTurk) crowdsourcing survey employed in 2018. Additionally, cognitive interviews were conducted with both providers and parents of 2- to 11-year-old children to assess screening question priorities and perceived added value. Results: The literature review identified 260 questions, and 20 items were selected with expert guidance based on prespecified criteria (simplicity and potential utility for both clinical interactions during a well-child exam and population health). MTurk surveys yielded 1147 records that met eligibility criteria and revealed 6 items that had adequate response variation and were significantly correlated with parent-reported child BMI or BMI percentile, exhibiting concurrent validity. Cognitive interviews with 10 providers and 20 parents uncovered themes regarding suggestions and usability of the questions, eliminating 3 items due to parent and provider concerns. Combining quantitative and qualitative results, 3 nutrition and physical activity screening items remained for inclusion into the electronic health record (EHR). Conclusions: The three-pronged validation methodology produced a brief, 3-item child nutrition and physical activity screener to incorporate in the EHR, where it can inform tailored counseling for well-child care and be used to test associations with population health outcomes.

Justifying by "healthifying": When expected satisfaction from consumption closure increases the desire to eat more and biases health perceptions of unhealthy leftovers.

Given ongoing concerns about worldwide obesity, a rapidly growing body of research has sought to identify factors that drive consumption of energy-dense foods and snacks with little nutritional value. The present research contributes to this literature by exploring the role of consumption closure-a state characterized by perceiving a given eating occasion as finished or complete-on people's desire to eat more. More specifically, four studies demonstrate that when a small (vs. large) quantity of unhealthy leftovers remains after a meal/snack-that is, when additional food consumption can feasibly provide consumption closure-the desire to continue eating is higher (vs. lower). Furthermore, and importantly, the present research uniquely demonstrates a "justifying by healthifying" effect wherein this desire to eat more is, in turn, justified by downplaying the unhealthiness of the food (i.e., perceiving it as less unhealthy or fattening). The findings thus provide evidence of an important antecedent to food-related behavior (consumption closure) and a unique downstream consequence (biased health perceptions).

Confession and self-control: A prelude to repentance or relapse?

Confessions are commonplace. Even when embarrassing or otherwise damaging, we seem intrinsically motivated to open up to others and confess mistakes we have made. Although there may be many reasons one might choose to disclose one's "sins," very little is known about what confession actually does, particularly concerning its effect on future behavior. This work examines confession in the context of one's personal self-control failures in consumption, asking the central question: does confession lead to repentance (i.e., enhanced subsequent self-control) or relapse (reduced subsequent self-control)? We predict and demonstrate that the effect of confession on ensuing behavior depends largely on the amount of guilt a confessor feels regarding their behavior prior to confession. Across five studies, we find that confessing (versus not confessing) high-guilt transgressions boosts subsequent self-control, whereas confessing relatively low-guilt indiscretions promotes further relapse. Further, initial evidence suggests that changes in self-discrepancy following a confession drive subsequent changes in self-control behaviors. A single paper meta-analysis demonstrates the robustness of our key effects and provides further support for the role of self-discrepancy in the underlying process. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The ability to choose can increase satiation.

The ability to choose should let people create more enjoyable experiences. However, in a set of 5 studies, people who chose repeatedly during ongoing consumption exhibited a greater drop in enjoyment compared with those who received a series of random selections from the same set of liked stimuli. Process evidence indicated that choosing increased satiation because it triggered overall reflections on the repetitive nature of the ongoing consumption experience. Moderating evidence also supported our theoretical account as differences in satiation disappeared when nonchoosers were explicitly cued to think about repetition in the general sense, or when choosers made all of their choices before the onset of repeated consumption. Additional measures and analyses further established that choice set size, the difficulty of choosing, and other alternative accounts could not fully explain the pattern of effects. The paper closes with a discussion of the implications of these findings for understanding the causes of satiation, the consequences of choosing, and improving individuals' experiences. (PsycINFO Database Record

Half-size me? How calorie and price information influence ordering on restaurant menus with both half and full entrée portion sizes.

Many restaurants are increasingly required to display calorie information on their menus. We present a study examining how consumers' food choices are affected by the presence of calorie information on restaurant menus. However, unlike prior research on this topic, we focus on the effect of calorie information on food choices made from a menu that contains both full size portions and half size portions of entrées. This different focus is important because many restaurants increasingly provide more than one portion size option per entrée. Additionally, we examine whether the impact of calorie information differs depending on whether full portions are cheaper per unit than half portions (non-linear pricing) or whether they have a similar per unit price (linear pricing). We find that when linear pricing is used, calorie information leads people to order fewer calories. This decrease occurs as people switch from unhealthy full sized portions to healthy full sized portions, not to unhealthy half sized portions. In contrast, when non-linear pricing is used, calorie information has no impact on calories selected. Considering the impact of calorie information on consumers' choices from menus with more than one entrée portion size option is increasingly important given restaurant and legislative trends, and the present research demonstrates that calorie information and pricing scheme may interact to affect choices from such menus.

Combining food type(s) and food quantity choice in a new food choice paradigm based on vice-virtue bundles.

Given the prevalence and rising rates of obesity in many countries, including the United States, much food decision-making research ultimately aims at understanding how consumers can make healthier choices. The two predominant choice paradigms used in food decision-making research ask consumers to choose (a) between a "vice" (or unhealthy food) and a "virtue" (or healthy food) or (b) among varying portion sizes of "vice." We propose a new food choice paradigm that encourages consumers to jointly consider both food type(s) choice and food portion size at each decision point. The purpose of this paradigm is two-fold. First, it aims to allow examination of more comprehensive eating behavior (e.g., to examine the overall composition of a plate of food rather than choice of a single food). Second, it aims to shift consumers towards including large proportions of virtues and smaller proportions of vice in their overall consumption portfolios. For this paradigm, we draw upon a recently introduced food product innovation called "vice-virtue bundles" (Liu et al., 2015) that illustrates the basis of this new food choice paradigm, in which food type(s) and portion decisions are made simultaneously. Accordingly, we first discuss relevant findings on vice-virtue bundles as well as the differences between simultaneous and sequential choice of multiple products. Second, we examine the benefits for managing and controlling one's consumption that are provided by vice-virtue bundles and this joint food choice paradigm more generally. Third and finally, we point out opportunities for future research by discussing (a) multiple factors that influence food choices, (b) decision processes affected by food choice paradigms, and (c) issues of generalizability related to the presence of vice-virtue bundles.

Physician counseling of overweight patients about preventive health behaviors.

BACKGROUND: Numerous studies show that many primary care physicians (PCPs) do not discuss preventive health behaviors related to diet and exercise with their overweight patients. PURPOSE: To investigate whether certain counseling approaches by PCPs in their clinical encounters with patients are associated with improvements in care and resource utilization. METHODS: A total of 2205 patients in a large HMO were surveyed, during November and December 2010, about their health behaviors and perceptions of their interactions with their PCPs. Survey responses from each patient were matched with 48 months of patient-specific medical claims data, from October 2008 through September 2012, capturing the frequency and monetary costs of health care utilization. A series of regression analyses, completed in June 2013, focused on four dependent variables: patients' intentions to improve diet and activity, patients' satisfaction with their physicians, visits to healthcare providers, and health plan spending on treatment. RESULTS: For each finding, the degree of physician-patient discussion of preventive health behaviors was strengthened when (1) physicians expressed confidence in patients' ability to improve diet and exercise and (2) patients had confidence that their physician could facilitate improvement of these behaviors. CONCLUSIONS: The associations between physician counseling and subsequent key improvements for overweight patients are strengthened by the physician's confidence in the patient's ability to engage in preventive health behaviors and the patient's confidence in the physician's ability to help in implementing these behaviors. Cultivating such mutual confidence is instrumental in optimizing physicians' influence on overweight patients' health behaviors.

In control of variety. High self-control reduces the effect of variety on food consumption.

The presence of variety increases the quantity of food a person wants and consumes. A recent review of past literature (Remick, Polivy, & Pliner, 2009) concludes that although external factors influence this effect of variety, internal factors do not seem to affect it. We identify general self-control as an internal factor that moderates the effects of variety in food. A series of three studies demonstrates that lower trait self-control makes one more susceptible to the variety effect, showing both greater increases in choice regarding the quantity of consumption and desire for more food in the presence of variety. Compared to those with low self-control, people with high self-control experience reduced enjoyment for a variety of foods following consumption of one food. This increased satiation would serve to diminish the variety effect and facilitate positive health outcomes over time.