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Consumer perspectives in Primary Health Care (PHC) need further exploration in Bangladesh. The study aimed to explore consumer-perception-based availability and accessibility of PHC services, along with equity, in a lower health outcome district.
Methods:
A cross-sectional study was conducted in the low-performing district, Moulvibazar. Adult Health Care Consumers (HCCs, n = 417), attending PHC facilities were purposively selected and data were collected through face-to-face interviews. Individual questions were weighted, and Self-Reported Availability Score (SRAvS) and Self-Reported Accessibility Score (SRAcS) were derived (0–100% scale). Equities in availability and accessibility were explored by analysing gender (male–female), location (rural–urban), and Income-Quintiles (InQ).
Findings:
Proportions of HCCs perceiving availability of services were low: laboratory diagnosis (19%), nutrition-health education (31%), basic emergency (49%), and ‘most of the time drug supply’ (18%). Of HCCs, 43% visited other facilities. Accessibility was fair (eg, waiting time ≤30 minutes for 86% and <one hour for 11%). Median SRAvS ranged from 42 to 52 with no difference between any of the two gender-, location-, or InQ-based groups. Median SRAcS ranged from 65 to 95 and it was significantly lower among urban vs rural (p < 0.001) subgroups. In the regression analysis, higher age (p = 0.041), female gender (p < 0.001) and urban location (p = 0.049) were found to be significantly associated with lower SRAcS.
Conclusion:
Comprehensive availability of PHC services is poor in a low-performing district of Bangladesh. Overall accessibility to PHC services is relatively better, but it is lower for urban consumers. Gender, location and socioeconomic status are important factors to modulate inequities in service availability and accessibility.
Chapter 3 explores perception as the process through which consumers select, organize, and interpret sensory information. It introduces absolute thresholds across senses and explains how marketers must ensure stimuli exceed these thresholds to be noticed. The chapter then examines subconscious (subliminal) perception, showing how below-conscious cues can subtly influence attitudes, emotions, and behavior. It provides rich examples of sensory marketing – visual design, tempo and rhythm in music, scent branding, tactility, and flavor – that shape consumer responses and brand meaning. The chapter also discusses how marketing creates images that can yield mirage effects that distort reality and fuel overconsumption. Finally, it contrasts these tendencies with conscious reality grounded in mindfulness that can help consumers see through illusions.
There is an increasing need to understand how rising environmental pressures and the EU’s PPWR (Packaging and Packaging Waste Regulations), which requires more sustainable and standardised packaging, affect brand identity. This paper evaluates how standardisation alters brand recognition and the extent to which visual and verbal cues can preserve brand identity and heritage. Mixed-method case studies show that coherent cues can maintain authenticity, brand meaning, and consumer acceptance emphasising the importance for brands seeking to balance sustainability with consumer perception.
Upcycling, the creative reuse of pre-existing materials, offers clear environmental benefits by reducing waste and conserving resources, while also promoting sustainable consumption. However, despite its potential, consumer understanding of upcycling remains limited, with many either unfamiliar with the term or conflating it with other sustainable practices. This conceptual ambiguity can undermine confidence in upcycled products, hinder market adoption, and pose challenges for businesses. The inclusion of branded materials in upcycled goods further complicates the landscape, raising legal and reputational concerns for trademark holders and prompting questions about consumer confusion and fairness. To investigate these issues, this chapter presents empirical insights from three studies involving 2,393 participants. Study 1 examines consumers’ understanding of upcycling. Study 2 explores how branded materials in upcycled products influence evaluations and manufacturer identification. Study 3 assesses the effect of different information about manufacturers on consumer perceptions and recall. Findings provide a foundation for considering the legality of trademark use in upcycling and inform strategies for promoting consumer awareness, supporting sustainable business models, and safeguarding both brand and consumer interests in the transition from a linear to a circular economy.
In health care systems based upon the principles of managed competition, health insurers are expected to act as prudent buyers of care. Consumers are expected to switch between insurers based upon the performance of insurers in this role. Yet, the Dutch experience shows that trust of consumers in health insurers is low and that switching consumers focus primarily on price. The question arises if consumers do in fact perceive and trust insurers as prudent buyers of care. We addressed this question by using a mixed-method approach. The results show that most people know that insurers buy health care and feel that the purchasing tasks suit their role. They even have reasonable, though fragile, trust in the purchasing competencies of the insurer. However, the results also revealed that consumers have insufficient information to cast a judgement about insurers as purchasers and incorrectly think that insurers are commercial organisations. Hence, improving the public information about insurers and their purchasing role seems to be crucial. Given the inherent complexity in the system, it remains to be seen if this objective can be reached in the (near) future. For that reason, policymakers should also consider additional measures to encourage that insurers will take integral purchasing responsibility.
Milk is a fundamental food matrix that is widely consumed. Milk fat is important for producing dairy products such as butter, cream, cheese and whole milk powder. Aside from flavour, it has been linked to human health and its chemistry can be modulated by various means towards a more healthy fatty acid profile. Industry and stakeholders have different interests in milk fat, based on specific policies which reflect the type of research and funding initiatives currently performed in different countries. This position paper summarizes the current state-of-the-art with regards to milk fat research and industry as well as stakeholder initiatives, and then highlights new developments based on information gathered from North America (United States and Mexico), Europe (United Kingdom, Spain, Italy, and Finland), Africa (Egypt), Asia (China and Bangladesh) and Oceania (New Zealand). South America is an important contributor to the dairy industry but will not be considered here and thus this paper must be considered cross-continental rather than global. This manuscript intends to show a wide ‘picture’ of milk fat from different angles in different parts of the globe.
With the wide availability of large language models and generative AI, there are four primary paradigms for human–AI collaboration: human-only, AI-only (ChatGPT-4), augmented human (where a human makes the final decision with AI output as a reference), or augmented AI (where the AI makes the final decision with human output as a reference). In partnership with one of the world’s leading consulting firms, we enlisted professional content creators and ChatGPT-4 to create advertising content for products and persuasive content for campaigns following the aforementioned paradigms. First, we find that, contrary to the expectations of some of the existing algorithm aversion literature on conventional predictive AI, the content generated by generative AI and augmented AI is perceived as of higher quality than that produced by human experts and augmented human experts. Second, revealing the source of content production reduces—but does not reverse—the perceived quality gap between human- and AI-generated content. This bias in evaluation is predominantly driven by human favoritism rather than AI aversion: Knowing that the same content is created by a human expert increases its (reported) perceived quality, but knowing that AI is involved in the creation process does not affect its perceived quality. Further analysis suggests this bias is not due to a ‘quality prime’ as knowing the content they are about to evaluate comes from competent creators (e.g., industry professionals and state-of-the-art AI) without knowing exactly that the creator of each piece of content does not increase participants’ perceived quality.
Consumer misperception and misinterpretation of food labels can lead to consumers not buying a product or purchasing products that do not align with their environmental or sustainability interests. Consumer purchasing behavior can be explained by looking at consumer food values or food quality attributes. This study aimed to (a) determine the effect label information has on consumer preference shares for selected sustainability-related food labels and (b) if correlations exist between food labels and food values. To the best of our knowledge, this is the first study to examine the comprehension of 12 different labels and identify how food labels relate to food value preferences. Responses from the best-worst scaling experiment of food value and environmental food label choice sets were analyzed using the random parameter logit model. Results reveal preference shares changed for each label as more information was provided to the respondents about the various labels included in the study. These findings should support food policy efforts requiring strict, clear label standards. Food labels should represent the food’s core food values to increase consumer preference for the product. These findings also further support the need for efforts to increase consumer knowledge and understanding of the labels on food packaging.
This chapter demonstrates that analyzing what people post on social media sites can yield powerful evidence for use in commercial litigation. This kind of analysis is a natural way of listening in on people’s conversations about products, services, brands, trademarks, and patents, all of which are often the subject of high-stakes lawsuits. An argument is made that an expert who could commission an opinion survey could now also commission a social media analysis, which will contribute to a more persuasive and often more time-appropriate body of evidence upon which to rely. Examples of the use or potential use of social media in litigation are presented, including cases that used social media evidence, such as the US government’s lawsuit against Lance Armstrong; a case involving a meat byproduct sometimes referred to as “pink slime”; a case centering on an allegedly deceptive Super Bowl beer advertisement; and many cases involving disputes having to do with intellectual property. Finally, we compile and discuss a number of issues relating to the use of social media in litigation. These issues include questions about social media’s authenticity, the best way to preserve it, and several other analytical and legal questions. The chapter concludes with a discussion of how social media analysis can migrate from the periphery of litigation evidence toward having a more central role.
The present study aims to assess the relationship between consumer perception and on-farm assessment of animal welfare performed using the Animal Needs Index 35L (ANI). Two tie-stall, 2 straw yard and 2 cubicle farms were scored by trained assessors using the ANI and filmed to produce six 3.5 min videos. Each of them contained 4 clips: barn overall view, feeding, milking and individual animals. Ten untrained observers were asked to elicit terms describing how they perceived the observed farming systems to affect animal welfare using Free Choice Profiling (FCP). Data from FCP were subjected to Generalised Procrustes Analysis (GPA). GPA showed a significant consensus among observers. Observers characterised the first dimension with terms ranging from constrictive to comfortable conditions and the second one in terms of cleanliness/dirtiness. Principal Component Analysis (PCA) was conducted using the scores of the farms on the first two dimensions of GPA and the data gathered through the ANI. The first dimension of GPA (Comfortable), ANI's sheet 1 (Locomotion), sheet 2 (Social interaction) and sheet 6 (Total score) showed high loadings on the first component of PCA, whereas the second dimension of GPA (Clean), sheet 3 (Flooring) and sheet 4 (Stockmanship) were correlated with the second component of PCA. We concluded that FCP may be used to elicit lay person perception of welfare-related characteristics of dairy cattle farming systems, thus providing a tool to study the relationships between consumer perception and on-farm assessment of animal welfare.
Front-of-pack (FOP) nutrition labelling is a globally recommended strategy to encourage healthier food choices. We evaluated the effect of FOP labels on the perceived healthfulness of a sweetened fruit drink in an international sample of adult consumers.
Design:
Six-arm randomised controlled experiment to examine the impact of FOP labels (no label control, Guideline Daily Amounts (GDA), Multiple Traffic Lights, the Health Star Ratings (HSR), Health Warning Labels, and ‘High-in’ Warning Labels (HIWL)) on the perceived healthfulness of the drink. Linear regression models by country examined healthfulness perceptions on FOP nutrition labels, testing for interactions by demographic characteristics.
Setting:
Online survey in 2018 among participants from Australia, Canada, Mexico, United Kingdom (UK) and United States.
Participants:
Adults (≥18 years, n 22 140).
Results:
Compared with control, HIWL had the greatest impact in lowering perceived healthfulness (β from −0·62 to −1·71) across all countries. The HIWL and the HSR had a similar effect in Australia. Other labels were effective in decreasing the perceived healthfulness of the drink within some countries only, but to a lower extent. The GDA did not reduce perceived healthfulness in most countries. In the UK, the effect of HIWL differed by age group, with greater impact among older participants (> 40 years). There were no other variations across key demographic characteristics.
Conclusions:
HIWL, which communicates clear, non-quantitative messages about high levels of nutrients of concern, demonstrated the greatest efficacy to decrease the perceived healthfulness of a sweetened fruit drink across countries. This effect was similar across demographic characteristics.
In most European countries, male piglets being reared for meat are physically castrated without anaesthesia in order to avoid boar taint and to safeguard sensory meat quality. This method is increasingly criticised for its violation of piglet welfare. Alternative methods are being researched and castration with anaesthesia or analgesia and vaccination (immunisation) against gonadotropin-releasing hormone (using Improvac®, Pfizer GmbH) have been proposed as possible solutions. In addition to efficacy, the successful introduction and adoption of the vaccine method by stakeholders in pig supply chains are expected to depend on a favourable reception by consumers. This large-scale quantitative cross-country study (n = 4031) involving representative samples of consumers in France, Germany, the Netherlands and Belgium does not support the reserved attitude of stakeholders who fear potential low market acceptance. The vaccine method was actually preferred by the majority of consumers surveyed (69.6% of the participants) and it was perceived as equally effective in terms of avoiding boar taint; 43.8% of the consumers reported an intention to seek out pork from pigs where the vaccine had been used to control boar taint, whereas 33.7% reported an intention to avoid pork from pigs physically castrated with anaesthesia. Consumers’ favourable dispositions to the vaccine method were independent of dominant ethical, health or price orientations when purchasing pork.
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