Social media food marketing landscape of children living in Republic of Srpska, Bosnia and Herzegovina: Piloting the WHO CLICK framework, results and lessons learned.

Abstract

Background: Monitoring food marketing that reaches children is key to effective implementation of any regulation. The Best-ReMaP European Union Joint Action aimed to test the feasibility of using monitoring protocols (developed by the World Health Organization's Regional Office for Europe [WHO-Euro]) in the public health sector, to inform EU-wide monitoring plans. In Republic of Srpska, BiH, we piloted the WHO 'CLICK' Framework step, 'L - Landscape of campaigns', created to assess the nature of digital food and beverage marketing that children are potentially exposed to when using their preferred digital media.

Methods: This mixed methods pilot study analysed 235 Instagram and Facebook posts from 10 brands/products popular among children in Republic of Srpska, and 24 videos of two YouTube influencers, between January-April 2023. The WHO Nutrient Profile Model (1st edition, 2015) was used to assess ads' eligibility to be marketed to children. With WHO-Euro monitoring Protocols we assessed the promotional techniques (ad's creative power) used by brands and YouTube influencers. Finally, we assessed feasibility at every step of the process.

Results: Research capacity and coding were among the main identified challenges in the pilot. Our learnings contributed to updates of the WHO Protocols and the EU- framework guidance. Regarding the food marketing landscape, the most frequently advertised food categories on social media and in YouTube Influencers' content were cakes, sweet biscuits and pastries (31% and 22.7% respectively) and chocolate and sugar confectionery (27.5% and 14.7% respectively). None of the social media ads were eligible to be marketed to children and only of 2 of the 24 YouTube influencers' marketing instances were eligible. Most ads featured elements potentially appealing to teens, 88% on Facebook and 72% on Instagram. The most frequently used persuasive appeals on social media were reference to holidays, travel, or adventure (23%), followed by taste (12.5%) and premium/contest (11.5%). YouTube influencers predominantly presented branded foods (62.5%). Only one influencer video featured a marketing disclosure. Food cue contexts varied between the two influencers, depending on their target groups. One mostly posted videos filmed at home, with child appeals and referred positively to the food featured; the other presented food as a secondary object and in neutral rather than positive contexts.

Conclusion: The WHO-Euro 'landscape' Protocol is a feasible tool for Member States to evaluate digital food marketing. Facilitators were: capacity/resources, access to a knowledge/experience exchange, and regular protocol updates. The analysis shows that in Republic of Srpska, BiH, powerful marketing of unhealthy foods appealing to children takes place on children's favoured social media platforms and via influencers with child-appealing content. Mandatory, government-led restrictions, accompanied by regular monitoring are needed to protect children's health.