Healthy Eating Strategy – Dietary Guidance Transformation – Focus Groups on Healthy Eating Messages, Visuals and Brands
Research Report

Earnscliffe Strategy Group (Earnscliffe) is pleased to present this report to Health Canada summarizing the results of qualitative research exploring the new Canada’s Food Guide visual, look-and-feel and supporting messages.

Health Canada is revising Canada’s Food Guide (CFG) to reflect the latest scientific evidence, and to be more modern and relevant to users. This includes a release of a suite of products using new communication tools to meet the needs of a variety of audiences. The new products include a CFG visual. In addition, a new CFG look-and-feel will be applied across the suite of products. The total cost to conduct this research was $208,218.47, including HST.

The research was conducted over two phases.

Phase 1
The objective of the first phase of research was to test a sample of messages to assess whether the various tones and styles resonated with the various audiences, with the goal to inform the development of final messages. Health Canada was interested in understanding whether the messages are: motivating; using the appropriate tone; providing the right amount of information to meet their desired needs; practical, relevant and helpful, given the task setting at hand.

The messages were targeted to five different audiences and focused on a variety of healthy eating topics. The five audiences included: adults experienced in food preparation; adults with minimal experience in food preparation; seniors responsible for food preparation; parents of children who are responsible for grocery shopping and food preparation; and, youth aged 16 to 18.

This phase included a series of ten focus groups across two cities – Ottawa (March and 20) and Quebec City (March and 21). The focus groups in Quebec City were conducted in French.

Phase 2
The objective of the second phase of research was to test the look-and-feel and visual elements for the new Canada’s Food Guide to assess: effective use of text and graphics/images; credibility, relevancy and perceived value to the audience; acceptance; appeal, usefulness and appropriateness; relevance and engagement; and memorability (eye-catching and general visual appeal).

Audiences for the second phase included: those at risk of marginal health literacy [as screened by the Newest Vital Sign (NVS) and scoring <4/6]; those with adequate health literacy (score 4+); primary level teachers; community level educators; registered dietitians working in public health or community nutrition; registered dietitians working in clinical/private practice/media/bloggers; and, registered nurses working in public or community health.

Ten focus groups were conducted with members of the general public in five Canadian cities: Toronto, ON (June 5, 2018); Quebec City, QC (June 6, 2018, in French); Calgary, AB (June 7, 2018); Whitehorse, YK (June 11, 2018); and, St. John’s, NL (June 14, 2018). Fifteen (15) mini-groups were conducted with health professionals and educators in three Canadian cities: Toronto, ON (June 4, 2018); Calgary, AB (June 6, 2018); and, Quebec City, QC (June 18, 2018, in French).

Please refer to the Recruitment Screener in the Appendix of this report for all relevant screening and qualifications criteria.

It is important to note that qualitative research is a form of scientific, social, policy and public opinion research. Focus group research is not designed to help a group reach a consensus or to make decisions, but rather to elicit the full range of ideas, attitudes, experiences and opinions of a selected sample of participants on a defined topic. Because of the small numbers involved the participants cannot be expected to be thoroughly representative in a statistical sense of the larger population from which they are drawn and findings cannot reliably be generalized beyond their number.

Phase 1

REACTIONS:

• While the information presented was not necessarily new to respondents, their overall reaction to the messages was quite positive. They felt the messages included important reminders and tips to help them build better health eating habits.
• Participants felt the tone of the messages was appropriate, however, they preferredpositive and friendly tips that presented advice as a suggestion, rather than messages with a negative, condescending, and imperative tone.
• The language was clear and easy to understand, albeit wordy and redundant at times. Participants preferred short, concise messages, with the exception of longer messages that provided specific advice, particularly for those with minimal experience in food preparation.
• Most participants tended to prefer messages with a rationale, arguing that it gave them the “why”. Their preference was similar to the earlier point about a preference for suggestive over imperative messages.
• Reaction towards messages about what and how to eat was mixed, though the findings suggest there is room for both in the communications. Those experienced in food preparation felt information about how to eat was new. Those with minimal experience in food preparation tended to prefer advice about what to eat that included specific instructions and a rationale.
• The advice was deemed practical. On many occasions, participants remarked (unaided) that they would take action as a result of something in the messages.
• There was some confusion around the title of a couple of topics: Beginner Cook and Celebrations. In English, Beginner Cook seemed to refer to young people learning to cook; while, Celebrations seemed to refer to family holiday traditions. Participants generally appreciated the advice in both topics although some participants were frustrated by the advice under Celebrations to forego or modify family traditions and recipes.
• Youth and parents had a similar reaction to the topic of Eating Out – both felt that eating out in restaurants was an infrequent occurrence and a time for indulgence, not sacrifice.
• Youth appreciated the topic of Eating on the Go for its specific snack ideas to eat during points in the day when they are both hungry and rushed. That said, they would not use the topic heading, Eating on the Go. Something to do with “snacks” seemed more relevant to them.
• Other topic areas upon which participants suggested included:
  • Advice related to Fueling Your Body for Sport/Exercise;
  • Eating Healthy on a Budget; and
  • Eating Healthy While Travelling (e.g. road trips).

Phase 2

REACTIONS: LOOK-AND-FEEL ELEMENTS

• The overwhelming majority of participants preferred the light blue concept with the illustration of the tagline for look-and-feeling purposes (Concept B). It was the look-and-feel concept that most described as warm, friendly, relatable, positive, interesting, and attention-grabbing. Participants described the illustration as a representation of Canada, including people in urban and rural settings, and depicting food from farm to table. This concept was most closely linked to food, though many felt that food could be depicted more clearly, citing examples such as apples in the trees, or crops and/or animals in the fields, etc.
• The green concept (Concept A) was eye-catching, but unappealing. Most found the green to be a little jarring and had trouble reading the tagline. Participants described the overall look as amateur and juvenile. They also felt this illustration suggested that this was Canada’s Food Guide for urban/city dwellers (given the heavy emphasis on buildings in the illustration). The majority of participants did not think this look-and-feel naturally fit with food or Canada’s Food Guide, nor did it tie in closely with the campaign tagline: Where You Live, Learn, Work, and Play.
  • Reactions to this concept worsened when participants were shown the web button formats. The placement of the buildings made the concept feel amateur.
• The plain blue concept (Concept C) was felt to be boring and “typical government”. Very few, if any, felt they would be interested or inclined to read the guide based on these look-and-feel elements. Participants also did not like that this look-and-feel concept did not have an obvious link to food or the tagline. However, of all three look-and-feel concepts, it was most often deemed modern because it was simple and minimalist.
  • For this reason, some participants thought that this concept worked well as a web button (the smaller format). This simpler format would be eye-catching and something they might click on.

REACTIONS: VISUAL ELEMENTS

• Overall reaction to the digital and print versions of both concepts was generally positive although many participants, particularly health professionals (in Quebec City), were slightly underwhelmed. In large part, this was in reaction to the digital concept which seemed to have two perceived weaknesses: 1) the lack of interactivity; and 2) the use of icons rather than real photos/images. The compounded effect of the two suggested an amateur product, not that different than the current Food Guide. However, impressions tended to improve when participants were shown the printed version of the “at-a-glance” concept, because all the information was visible at a glance on one page, as opposed to the digital experience which required scrolling to get the full picture. Impressions of the digital experience improved once participants were told that the intention was to create an interactive experience.
• The majority of participants felt that both digital and print versions would be useful.
  • Health professionals and educators would use the digital concept with their target audiences and then send them home with a printed version to put up on the fridge.
  • Members of the general public felt they would use the digital version when they were shopping or preparing their grocery lists, and tack a printed version up on their fridges.
• Participants were surprised and encouraged to see new information that encourages healthy eating behaviours, featured so prominently, in addition to advice about healthy food choices.
• In terms of overall look and feel, participants generally seemed to coalesce around Concept B (blue background), particularly when they were shown the printed version, due to:
  • The overall professional quality;
  • How the illustration complemented the tagline and food;
  • The number and size of food icons; and,
  • The clarity of the black font against the blue background.
• In terms of the presentation/order of information, preferences were mixed but most tended to prefer the order of Concept B. They suggested that this order allowed them to very quickly get information about how to eat and what to eat, which they felt was a positive start, followed by information about what to limit. Those who preferred the order of Concept A preferred to understand how to eat and what to limit, and then equipped with that information, they could move to what to eat.
  • Of note, almost all participants tended to prefer the order of Concept B in the printed version, with suggestions for adjustments to some of the icons. These adjustments included suggestions like using the food icons for “Limit foods high in sodium, sugars or saturated fat” instead of the warning label.
• Respondents were confused about what the icons represented and felt they could be improved. Participants felt the icons in the how to eat section (i.e., cook more often, eat with others, etc.) were sterile and impersonal. They suggested including people in the visuals. In terms of the food icons, participants were generally confused by the: squash, bagged lettuce, frozen berries, wild rice, oats, quinoa, brown rice, whole grain pita bread, tofu, peas, lentils, and the pork chop.
• The inclusion of canned and frozen goods was met with mixed reaction. Those in favour argued that it was important to include economical and time-saving food options. Those opposed argued that they could lead Canadians to making unhealthy choices (i.e., processed foods), but also that the depiction of packaged goods promotes the use of excessive packaging.
• Unprompted, most participants did not infer much in the way of proportionality. When asked, some could delineate that because vegetables/fruits occupy a larger space visually, or in the example of Concept B that vegetables/fruits were displayed at the top, that most of their food should come from this category.
  • Most indicated that they would have preferred a more direct reference to either specific proportions or an image that illustrated proportions.

Health Canada is revising Canada’s Food Guide (CFG) to reflect the latest scientific evidence, and to be more modern and relevant to users. This includes a release of a suite of products using new communication tools to meet the needs of a variety of audiences. The new products include a CFG visual. In addition, a new CFG look-and-feel will be applied across the suite of products. The research was conducted over two phases.

Phase 1

The objective of the first phase of research was to test a sample of messages to assess whether the various tones and styles resonated with the various audiences with the goal to inform the development of final messages. The messages were targeted to five different audiences and focussed on a variety of healthy eating topics. Each topic and task was specific to the target audience.

The specific objectives of this phase were to assess whether the supporting messages help various audiences make healthier choices in their everyday lives, including: applicability; clarity; credibility; tone and relatability. For each audience, Health Canada wanted to understand whether the messages are: motivating; using the appropriate tone; providing the right information (to meet their desired need); practical, relevant and helpful, given the task/setting at hand.

Phase 2

The objective of the second phase was to test draft concepts of the CFG look-and-feel and visual elements (digital and print versions). As these elements are being developed to be the face of “Canada’s new Food Guide”, Health Canada wanted to ensure that the look-and-feel and visual elements were adequately representing the new Guide.

The specific objectives of this phase were to collect feedback on the draft CFG visuals and look-and-feel elements that will appear across all tools, resources and social media, particularly around:

• effective use of text and graphics/images;
• credibility, relevancy and perceived value to the audience;
• acceptance;
• appeal, usefulness and appropriateness;
• relevant and engagement; and,
• memorability (eye-catching and general visual appeal).

Phase 1

To meet the objectives for Phase 1, Earnscliffe conducted a wave of qualitative research. The research included a series of ten focus groups across two cities – Ottawa (March 20 and 21) and Quebec City (March 21 and 22). The focus groups in Quebec City were conducted in French.

In each city, the first day included two groups: adults experienced in food preparation and adults with minimal experience in food preparation. The second day included three groups: seniors, youth (16-18), and parents. The sessions were approximately two hours in length with between eight (8) and ten (10) participants. Participants received an honorarium (of $100.00) as a token of appreciation for their time.

Phase 2

To meet the objectives for Phase 2, Earnscliffe conducted a wave of qualitative research. In total, the research included a series of twenty-five focus groups across the country.

Ten (10) focus groups were conducted with members of the general public in five Canadian cities: Toronto, ON (June 5, 2018); Quebec City, QC (June 6, 2018); Calgary, AB (June 7, 2018); Whitehorse, YK (June 11, 2018); and, St. John’s, NL (June 14, 2018, in French). The groups were divided in two segments (those who have marginal health literacy with scores of less than 4 on the Newest Vital Sign (NVS), and those with adequate health literacy, scoring at least 4 on the NVS). The groups were up to two hours in length. Fifteen (15) mini-groups were conducted with health professionals and educators in three Canadian cities: Toronto, ON (June 4, 2018); Calgary, AB (June 6, 2018); and, Quebec City, QC (June 18, 2018, in French). The groups were one hour in length.

Phase 1

The focus groups were conducted with Canadian adults experienced in food preparation; adults with minimal experience in food preparation; seniors responsible for food preparation; parents of children who are responsible for grocery shopping and food preparation; and, youth aged 16 to 18. Each group included a mix of sexes, ages, household incomes, education levels, as well as a mix of cultural backgrounds, including Indigenous peoples. Please refer to the Recruitment Screener in the Appendix of this report for all relevant screening and qualifications criteria.

Phase 2

The ten general population focus groups were conducted with those at risk of marginal health literacy [as screened by the Newest Vital Sign (NVS) and scoring <4/6)]; while the second group was conducted with those with adequate health literacy (score 4+). Each group included a mix of sexes, ages, household incomes, education levels, as well as a mix of cultural backgrounds, including Indigenous peoples.

The fifteen mini-groups of nutrition and/or health professionals and educators included: primary level teachers; community level educators; registered dietitians working in public health or community nutrition; registered dietitians working in clinical/private practice/media/bloggers); and, registered nurses working in public or community health.

Please refer to the Recruitment Screeners in the Appendix of this report for all relevant screening and qualifications criteria.

It is important to note that qualitative research is a form of scientific, social, policy and public opinion research. Focus group research is not designed to help a group reach a consensus or to make decisions, but rather to elicit the full range of ideas, attitudes, experiences and opinions of a selected sample of participants on a defined topic. Because of the small numbers involved the participants cannot be expected to be thoroughly representative in a statistical sense of the larger population from which they are drawn and findings cannot reliably be generalized beyond their number.

Phase 1

Except where specifically identified, the findings in this qualitative report represent the combined results for both English and French. These findings are discussed in two sections. The first section presents the findings of the initial exploratory (warm-up) discussion on expectations for healthy eating messages on the three topics relevant to each audience. The second section explores specific reactions to the messages in terms of their clarity, understandability and relevance; as well as, whether the tone and approach of the message was helpful and appreciated.

The following table outlines the topics that were explored for each audience. The specific messages for each can be found in Appendix B.

• Adults experienced in food preparation
  • Healthy eating at work
  • Grocery shopping
  • Eating on the go
• Adults with minimal experience in food preparation
  • Healthy eating at home
  • Beginner cook
  • Celebrations
• Seniors responsible for food preparation
  • Building healthy meals & snacks
  • Eating on a budget
  • Healthy eating for seniors
• Youth
  • Eating on the go
  • Building healthy meals & snacks
  • Eating out
• Parents responsible for food preparation
  • Planning & preparing healthy food with the family
  • Packing healthy lunches
  • Eating out

EXPLORATORY DISCUSSION
The focus groups began with an initial exploratory discussion around healthy eating. This discussion helped set the stage for a more detailed conversation about healthy eating on the specific topics relevant to each audience but also provided useful context for understanding participants’ expectations of government messaging on these topics.

Healthy eating at work
Adults experienced in food preparation

Adults experienced in food preparation expected, and wanted, to hear messages about bringing their own lunches to work. This was viewed as the healthiest and cheapest way to eat during the day. Easy and varied lunch ideas would be welcome, along with advice about what to eat to keep you energized throughout the day. Participants also asked for advice regarding dealing with allergies in the workplace.

Grocery shopping
Adults experienced in food preparation

When it came to grocery shopping, participants requested ideas on best practices, including meals based on in-season produce, how to plan meals ahead of going to the store, and which areas of the store to avoid (e.g. stay away from the processed foods in the aisles, and spend more time in the produce section). They were also concerned about the cost of buying healthy groceries, and welcomed tips about how to eat healthy and save money and how to avoid wasting food. Finally, many mentioned the importance of reading labels as they shop to assess the nutritional value of items and thought it would be helpful to remind people how to read labels.

Eating on the go
Adults experienced in food preparation and youth

Adults experienced in food preparation and youth alike were open to tips about how to eat healthier on the go. A few brought up the idea of fueling, rather than simply feeding, and this concept was reflected in many of the comments from other participants. They wanted to know what snacks fill you up and have some nutritional value. Some offered their own ideas – nuts, protein bars, fruits and vegetables – while others requested further suggestions that they could prepare quickly and cheaply. Many youth also brought up the importance of planning out snacks ahead of time for days they knew they would be busy. Both adults and teens acknowledged that sometimes eating on the go means eating from a fast-food restaurant if there are no other options available. In those cases, they wanted to know how to make healthy choices.

Healthy eating at home
Adults with minimal experience in food preparation

On the topic of eating healthy at home, adults with minimal experience in food preparation expected a wide variety of messaging and advice. They felt that healthy eating can be affordable and simple but would like to see that message reinforced with specific ideas. They were interested in learning about new ingredients, as well as where their food comes from. They were open to tips on time management and how to read food labels. They also specifically mentioned it was important to follow the food guide and be cognizant of proper portions, based on activity level.

Beginner cook
Adults with minimal experience in food preparation

As we will see later in this report, there was some confusion in English as to the meaning of term “Beginner cook” and to whom it referred. Based on their assumption of the meaning, adults with minimal experience in food preparation asked for quick, easy recipes you could teach to children as well. They also mentioned more rudimentary cooking skills, including knowing when food is ripe, when meat is cooked, food safety lessons, learning simple and essential cooking techniques, and buying the right cooking equipment. They also felt this category could include tips on how to cook healthy meals and trying new foods from around the world. Information about additional resources (websites, magazines, blogs) was also considered appropriate.

Celebrations
Adults with minimal experience in food preparation

Like “Beginner cook”, there was some confusion as to the meaning of “Celebrations”. Adults with minimal experience in food preparation seemed to infer this referred to special family gatherings (such as Christmas and Thanksgiving). Participants felt the topic would include tips on healthy alternatives to heavier options, how to reduce refined sugar in dishes prepared for celebrations, and how to identify healthier options in social settings. Several also mentioned food safety, particularly preparing food for a group of people who may have allergies. A few felt the topic would also include cautions around overindulging in food and alcohol.

Building healthy meals and snacks
Seniors responsible for food preparation and Youth

While there were some similarities, teens’ and seniors’ interests and expectations around building healthy meals and snacks varied in some respects based on health sensitivities and experience cooking. They were both interested in ensuring they were eating the correct portions from all the food groups. However, teens were more likely to specifically mention eating more fruits and vegetables as a key part of building healthy meals, while seniors wanted advice on how to eat less sodium, asked for diabetic friendly recipes, and how to reduce meat consumption. Seniors also expressed being tired of their usual meals and wanting more variety and advice on using what is on hand/leftovers to make nutritious meals. Teens were simply looking for easy recipes that are appetizing and healthy. Both wanted more information to, as one teen put it, “stop the confusion” around healthy eating. For seniors, this included information about omega 3’s, supplements, and GMOs.

Eating on a budget
Seniors responsible for food preparation

Seniors believed that good food is not always cheap, and consequently wanted to know more about how to maximize value, reuse leftovers for lunches, where to shop for cheaper produce and how to buy more economical items such as cheaper cuts of meat. They acknowledged that cutting out junk food was important, along with eating more vegetables.

Healthy eating for seniors
Seniors responsible for food preparation

Many seniors offered ideas and suggestions about how to eat healthier. They emphasized the importance of reducing salt intake, as well as sugar, fat and alcohol. They wanted to know more about special nutritional requirements for seniors, for example how much calcium they need. They also welcomed ideas as to how to better cook for one or two people, and further guidance on portions.

Eating out
Youth and Parents responsible for food preparation

Teens and parents identified similar themes on the topic of eating out – they would like to know more about the nutritional information of meals when they eat out, and they acknowledge it can be expensive and should not be a regular habit. Parents in particular asked for advice about eating out on a budget. Both wanted more clarity about calorie counts. Parents were a little more specific in their questions. Apart from calorie counts, they felt it was preferable to look for local restaurants that have more natural food choices, and offered more tips to reduce calories, fat, salt and sugar, including opting for water as a drink, having a soup or salad instead of fries, and looking for “hidden” salt and sugar in sauces.

Planning & preparing healthy food with the family
Parents responsible for food preparation

For parents, this topic should include both the “what” and the “how” of meal preparation. They asked for tips on what to make – how to avoid salt and carbs, emphasize veggies and sneak healthy foods into dishes for picky eaters. They also expected advice about how to make healthy meals for their family, including involving the whole family in meal planning, planning ahead, and which meals are most affordable for large families.

Packing healthy lunches
Parents responsible for food preparation

The messages and advice parents would like to see about packing healthy lunches was similar to planning and preparing food for their family. They would like more quick, simple lunch tips, including how to plan ahead and make healthy lunches that are lower in sugar and sodium, and include more vegetables. Some wanted advice regarding which beverages to pack, while others reported that they always send their children to school with water. They also felt that this topic should address food safety in schools, including snack ideas for foods that are permitted in schools (that do not include nuts, for example) and what foods need to be kept cool.

MESSAGE TESTING
The fundamental part of the focus groups explored participants’ reactions to the healthy eating messages on three topics relevant to each audience to determine whether they were clear, understandable and relevant, as well as whether the tone and approach of the message was appropriate, helpful and appreciated.

The following summarizes the overall reactions and general findings; a more detailed analysis of each audiences’ reactions follows.

• Overall reaction to the messages was generally quite positive; and, based on the warm-up discussion, generally in line with participants’ expectations for each topic. While participants felt that a lot of the information was not necessarily new, the majority came away thinking it was important to be reminded of these kinds of things to help them eat better.
• Participants felt the tone of the messages was appropriate; they were generally characterized as helpful advice about how to eat healthier. Participants preferred positive, friendly and suggestive messages over negative, condescending, and imperative messages. Participants found most of the messages tested to be positive and very few were perceived as negative.
• The language was clear and easy to understand, albeit wordy and redundant at times. Participants suggested short, concise messages, with the exception being messages that were longer because they provided specific advice, particularly for those with minimal experience in food preparation.
  • Given the choice between messages with specific or non-specific advice, those with minimal experience in food preparation and youth tended to prefer specific messages, arguing that the non-specific messages read as general messages and were not felt to be prescriptive enough.
• Most participants tended to prefer messages with a rationale. The rationale, they argued, tells them why and refers to the earlier point about a preference for suggestive over imperative messages. It was also interesting to note, that often times the rationale that mattered most to participants was not always the health rationale, but could also include saving time, saving money, etc.
• Reaction towards messages about what and how to eat was mixed, though the findings suggest there is room for both in the communications. Those experienced in food preparation felt information about how to eat was new and useful. Those with minimal experience in food preparation tended to prefer advice about what to eat; arguing that the messages should be specific identifying what to eat and why (rationale).
• The advice was deemed practical. On many occasions, participants remarked (unaided) that they would take action as a result of something they read in one or more set of messages. Most suggested this could lead to a simple shift in their own behaviours or that it could result in changing behaviours that might affect others living in the household (i.e., spouses, partners, children, etc.); both potential outcomes were seen as positive.

Audience-Specific Analysis
Participants were provided with the complete series of messages for each of three topics (as outlined earlier). They were asked to circle words or phrases that they liked or found compelling and to underline words or phrases that they did not like or did not find compelling.

The following summarizes the reactions for each audience, with reference to some of the messages as examples where relevant.

Adults experienced in food preparation
Reaction to the messages among adults experienced in food preparation was mixed. Overall, they felt the advice was credible, but mostly common sense, reinforcing behaviour people already know is healthy, and discouraging behaviour they know to be unhealthy. For each topic – Healthy eating at work, Grocery shopping and Eating on the go – participants were able to identify several messages that they liked and disliked, or dissect them to highlight the information they found most relevant.

In terms of message delivery, participants preferred messages that were presented as suggestions, rather than messages written in the imperative. The latter tended to come off as insulting or condescending. Participants felt the messages made assumptions about their own eating habits and judged them for it. A few examples of messages participants felt were condescending included, “Are you in charge of providing snacks for the next meeting? Serve whole wheat pita bread with hummus instead of donuts or cookies” and, “Replace French fries with a side salad and have the dressing on the side when you order a meal from the cafeteria.” For both, participants felt the messages assumed they had unhealthy eating habits such as eating donuts at meetings and choosing fries rather than a salad at their cafeteria. However, the suggestions for replacements themselves were not received negatively. One participant pointed out that serving healthier options at work meetings was a very good idea, and at times it is not helpful to “sugar coat” advice.

Participants reacted more positively to the messages that were framed as suggestions and offered advice to improve the imperative messages. For example, participants suggested that the statement, “Are you in charge of providing snacks for the next meeting? Serve whole wheat pita bread with hummus instead of donuts or cookies” could be improved by replacing “serve” with “try” or “consider”. Participants liked the statement, “Do you find yourself snacking a lot at work? This could be because of boredom or stress. Try taking a brisk walk instead” because the use of the word “try” lends some positivity to the tone.

The group preferred messages they perceived to be simpler, rather than specific. In many cases, they felt the specificity provided unnecessary or obvious information that obscured a simple and important message. A useful example of a statement participants felt could be shortened was, “Coffee shop muffins or bagels may seem like a good choice when you’re on the go. However, they’re often loaded with sodium, sugars and saturated fat. Plan ahead and pack your own healthy snack.” Participants liked the last sentence, but felt the rest of the statement was too wordy and unnecessary. Messages that they felt were simple and to the point included, “Include healthy snacks when planning your meals and add them to your grocery list. What you keep in the cupboards and fridge is what you will snack on!”

Participants had mixed views when it came to providing a rationale in the messages. In some cases, they felt it could be removed to shorten the statement. The following statement elicited both reactions: “Be a savvy shopper and look beyond the packaging. Foods labels will help you make an informed decision. Use labels to compare between products.” Some felt it was to the point and straightforward, while others felt the rationale (Food labels help you make an informed decision) was unnecessary. Participants welcomed the rationale in the messages, “Eating with your colleagues can be a great way to share recipes and learn about new foods” and “Successful grocery shopping starts with a plan. Write down your meal and snack ideas on a piece of paper, a meal planner or your cell phone.” Notably, both were also perceived to be short and to the point.

Adults with minimal experience in food preparation
Overall reaction to the messages was mixed and mostly related to some confusion around two of the topics - Beginner Cook and Celebrations.

The title “Beginner Cook” was confusing (in English) to adults. Adult participants thought that the term referred to young people (adolescents) learning to cook or those new to cooking, generally. Worth noting, the French translation, Cuisinier débutant, was not confusing at all and very accurately conveyed the intent to describe those (of any age) with minimal experience in food preparation. The messages worked very well in French. And, setting aside the confusion regarding the title in English, participants generally liked the messages and felt they were useful although some adults with minimal experience in food preparation (in Ottawa) felt that the information was not all that new.

The confusion around the topic of Celebrations was that the term inferred infrequent family holiday celebrations (i.e., Thanksgiving, Christmas, and/or Easter dinners) and did not naturally capture occasions to gather socially. In the absence of that context, participants were slightly offended by the advice that they should forego or adapt traditional family recipes (that they eat two to three times a year) to eat healthy. When provided with that context – that Celebrations also refers to social gatherings – reactions to the messages were much better received.

In terms of message delivery, participants preferred the messages that came across as conversational or helpful. For example, the following message was thought to be inviting, positive, supportive and encouraging: “Whole grains are wholesome! Enjoy a wide variety each day. Whole grains include whole wheat pasta, barley, brown or wild rice, oats, buckwheat, rye and flax.” Participants particularly liked the use of the word “enjoy”. They reiterated this when explaining that they liked the phrasing in the first sentence of the following statement: “Take time to eat and enjoy your food. Start with small portions and eat slowly. Take a break before reaching for seconds.” Participants rejected messages that came off as an instruction such as, “Avoid snacking when you are reading, working and watching TV. You are more likely to eat more if you are distracted.” Some felt this statement had a “nagging” tone, and while they acknowledged that they do often eat junk food while they watch TV, this statement is not something that would make them change their habits. They also felt the statement ignored that there are healthy snacking options one can have while watching TV.

Though it was not unanimous, participants’ preference was for messages with a rationale. In the statement about whole grains above, many questioned why whole grains are wholesome, and would have liked a short explanation. Some also felt a rationale was necessary in the following statement: “Instead of sugary drinks, try refreshing sparkling water made with cucumber slices or limes.” Participants felt the rationale was appropriate in the statement, “Vegetables and fruit do not have to take long to prepare. Take some time to prepare for the week ahead. Washed carrots, cucumbers, cherry tomatoes, apples and oranges make good grab-and-go snacks.” They felt it was useful to highlight that vegetables do not take long to prepare. Respondents who are also parents added that a rationale can be helpful to explain choices about healthy eating to their children.

Rationale was more important for messages regarding Celebrations than for other topics. Participants felt that if they were to be convinced to eat healthy at a time where they feel it is appropriate to indulge, they would need a good reason. An example of a statement that provided a compelling rationale was, “Cut your chance of overeating at special events by eating regularly during the day. No skipping meals. Curb your hunger before an event with a small, healthy snack an hour before you go out.” Participants felt this piece of advice was something they might actually be able to do ahead of a party.

Compared to the adults who had more experience in food preparation, this group preferred messages with greater specificity, and advice about what to eat. In the statement, “Whole grains are wholesome! Enjoy a wide variety each day. Whole grains include whole wheat pasta, barley, brown or wild rice, oats, buckwheat, rye and flax.”, they appreciated the list of options. Response was similar for, “Eggs can be good for dinner. Prepare them poached, scrambled or made into an omelette with any vegetables in your fridge for an easy supper.” They appreciated the options provided, and noted that it was still a fairly simple statement. They felt some messages needed more detail, such as, “Have beans and lentils often. They’re high in protein and fibre, and are low in saturated fat.” Participants wanted a few examples of easy meals using lentils or beans. That said, they also appreciated shorter messages, such as, “Try at least one new vegetable or fruit each week.” This was viewed as simple, good advice for picky eaters. Similarly, though they preferred the advice about what to eat, when asked, a number of participants felt that advice about both what to eat and how to eat would be helpful.

Seniors responsible for food preparation
Overall reaction to the messages was generally quite positive. Seniors appreciated most of the advice and felt that they could very easily incorporate many of these tips into their eating habits right away. The three topics – Building healthy meals & snacks, Eating on a budget, and Healthy eating for seniors – were of interest and the advice for each was felt to be relevant and in line with their expectations. Indeed, the majority were pleasantly surprised to see many messages on the topic of sodium and salt reduction which was certainly expected but also a topic of great interest to them.

In terms of message delivery, seniors appreciated messages that were written in a friendly and positive manner. There was a sense that they would be more likely to read encouraging and/or suggestive messages to messages written in the imperative.

A good example of a statement that was friendly and positive was, “There’s no right or wrong way to plan meals. Some people like to plan for the whole week while others plan for a couple of days. Do what works for you.” Participants understood the value of meal planning but appreciated the suggestion that they could tailor it to their needs and “do what works for [them]”.

In large part, this is based on their age and the number of years they have been preparing food. Indeed, most felt that they had learned a lot over the years about healthy eating which is not surprising given the number who spoke of having to live (either personally or a loved one) with certain health conditions (i.e., high blood pressure or cholesterol levels, diabetes, etc.). Much of the advice they have been provided by doctors to deal with these conditions relates to healthier eating practices and exercise.

Messages written in the imperative, therefore, particularly about things they already know, were not always received well. For example, an order to stop doing something, “Skip the butter when you are eating breads and rolls”, especially related to something they had already excused themselves or have come to understand that the alternative (margarine) is less healthy, was a little irritating and confusing to some. Some suggested: “Consider skipping the butter…” or “Try and cut back on the butter….” as more friendly and positive variations.

In terms of statement composition, providing a rationale was felt to be useful particularly for messages about emerging facts (i.e., non-meat protein options, healthy fats, etc.) as this was new information for which they would like to understand the justification. However, the placement of the justification seemed to be pertinent. For example, participants reacted favourably to the statement, “Eggs are a very convenient and versatile protein food. Prepare them poached, scrambled or made into an omelette with your favourite chopped vegetables.” because the justification (that eggs are convenient and versatile) was provided at the outset. By way of contrast, reactions to “Eat meatless meals more often! Instead of meat have baked beans, lentil chilli or an egg sandwich. They cost less!” were less favourable because the justification was provided at the end (they cost less). Some argued that as a result, this statement came across more as a directive to avoid something they enjoy (eating meat). Finally, in terms of the rationale, providing a rationale about something that was common sense, “Water is often the cheapest option. Make water your drink of choice and avoid the extra costs of other beverages.”, was felt to be slightly facetious. Participants thought it would be more compelling to link the benefits of water to healthy eating than cost.

On the question of specificity, it seemed to be hit and miss for this audience. Depending on the person, it was either the case that the specificity was a helpful aspect that provided a ready-made solution or that it was something that caused them to immediately disregard the statement. Participants felt the following was a good example where specificity was helpful: “Add less salt when cooking. Flavour foods with lemon, herbs or spices instead of salt.” An example where they felt specificity detracted from the statement was, “Drain and rinse canned vegetables to lower the sodium content.”, as the advice runs contrary to participants’ beliefs; many participants assumed that canned vegetables were not nearly as healthy as fresh or frozen vegetables. On some occasions, the lack of specificity was cited as a reason why a statement stops short of being helpful: “Variety can make food more appealing. Include different kinds of healthy foods in your meals.” Participants felt this was good advice but too general and would have liked specific examples of how to add variety to their meals.

Finally, in terms of the advice about “what you eat” versus “how you eat”, for seniors, while there was a preference for advice about “what to eat”, both were seen as helpful and compelling. Again, with respect to “what you eat”, preference was for positive advice with specific suggestions about what to eat with rationale up front especially about something they are less familiar. In terms of “how you eat”, the most powerful messages tended to include:

• Eating with others. This was particularly relevant and important for this audience especially as they explained they feel more and more isolated as they grow older. Children and grandchildren visit less and less frequently and they often find themselves alone.
• Celebrating at home instead of at a restaurant as a way to eat healthy on a budget.
• Being more strategic about taking advantage of seniors’ discounts and advantages. Indeed, as we will see later in this report, tips for healthy eating on a budget was something of interest to most participants.

Youth
The youth participants’ reaction to the messages was overall positive, with a few exceptions. They thought the messages were appropriate in the sense that they were almost all clearly related to healthy eating. Participants particularly appreciated the messages related to Eating on the go, but were open to the messages provided for the topics Eating out and Building healthy meals and snacks. Eating on the go appealed to this audience in particular because it highlighted some “pain points” where they are eager for healthy eating tips. These included helping them figure out what to eat when in a rush in the morning, between school and dinner, or when transitioning from school to extra-curricular sports.

As with most other audiences, youth preferred positive messages framed as a suggestion, rather than those written in the imperative. It was important that the messages avoid sounding condescending, or “like a mom”, as one participant described the following message: “Next time a friend asks you to go out to eat, think about whether you’re actually hungry. If not, suggest another fun activity.” Participants felt that the message, “Do you get hungry at your after school activity? Make a healthy snack that you can bring along” would be improved by replacing “make” with “try”. In a similar vein, they liked the statement “There are many different vegetables you can add to your meal. Trying new foods can help you learn about what you like” because it offered a suggestion for behaviour change, rather than a command.

While the teen participants preferred messages they found more positive, at times their interpretation of the message (as positive) was because a statement that was intended to be serious came off as humorous. The following provides a useful example: “Say yes to water with your meal. It’s a cost-free thirst quencher.” Teens found the second sentence in the statement comical, but the overall message was still effective and they appreciated the tone. This suggests that there is a fine line between messages that are comedic yet effective, and corny and ineffective.

In terms of structure, posing a question can work, but can also backfire. Participants felt the following was too long and obvious, “Do you get hungry at your after school activity? Make a healthy snack that you can bring along.” It would be more effective if the first sentence was shortened to simply say, “Hungry at your after school activity?”. The statement, “Do you feel too rushed to eat in the morning? A piece of fruit and a handful of nuts are a quick option to start your day” could be easily improved by instead saying, “Too rushed in the morning?”. Overall, the fewer words, the better.

There was no strong preference one way or another for messages about what versus how to eat. Participants for the most part felt both could work. However, one participant who favoured “how” messages did so because they were easier to adapt and apply to everyday life, such as planning ahead and packing snacks, or making an effort to take a water bottle along everywhere you go.

Specific suggestions were well received as long as they were helpful and plausible. Some liked messages that laid out instructions, informing them how to prepare foods they might not have tried to make before such as, “Beans and lentils are a great source of protein. Try healthy oven roasted chickpeas. Add a dash of olive oil, cumin and chilli powder to a can of drained chickpeas and roast them at 400o F (200 °C) for 30-40 minutes.” The instructions ensured that the statement felt simple and doable. However, if participants felt the statement presented an unrealistic option, they responded negatively. Rather than asking teens to make the perfect choice, it may be more helpful to suggest they make a better choice. A few examples participants found to be unrealistic included:

• “Snacks like muffins and cookies can be high in sugars and saturated fat. Try swapping them for plain lower fat yogurt with a piece of fruit.” Participants felt they would consider the advice in the statement if instead it asked them to look for a lower fat muffin, or simply switch to low-fat yogurt, rather than low fat and plain – the latter was taking the advice a step too far beyond what they felt they could reasonably see themselves doing.
• “Most people think of eating out as a treat. Try thinking of the time you are spending with friends or family as the treat rather than the food you choose.” Participants said that, to a certain extent, they already consider spending time with family and friends as a treat when they go out. It may be more effective to suggest that when going out with family or friends, enjoy your time, but try to make healthier choices.
• “Next time a friend asks you to go out to eat, think about whether you’re actually hungry. If not, suggest another fun activity.” This did not make sense to participants. They said that if they were not hungry but a friend wanted to go eat, they would just tag along and not order anything.

Of note, the participants did not appreciate messages that included references to more detailed nutritional information, such as, “Prepared and frozen entrees can be tempting because they are convenient. These foods are often high in sodium and saturated fat. Compare the nutrition labels on these products to make informed food choices.” They are conscious of “healthy” versus “less healthy” choices, but not because they are particularly concerned about the saturated fat content, for example.

Parents responsible for food preparation
Parents’ reaction to the messages often varied widely depending on the age(s) of their children. For example, some parents felt the following statement would not be appropriate advice for those with younger children, “Kids of all ages can help prepare the vegetables and fruits for their lunch. They can wash, peel or chop.” Reaction to advice regarding eating out also varied depending on the participants’ children’s ages. They highlighted that managing what an 8-year-old eats at a restaurant is very different than managing what a 17-year-old eats. It may be helpful to consider including the age of the child in the message in order to ensure it is noticed by the right parents.

Reaction to the messages about Eating out also proved unique in a couple of other ways. First, participants tended to think Eating out referred to a sit-down restaurant meal, and not their daily visit to coffee shops or cafeteria choices. Second, participants believed that eating out is a treat - an explicit decision to temporarily excuse less healthy choices. Therefore, messages about eating out may be better received if the advice is tempered with recognition that rationalization, and the knowledge that when we eat out, we are already aware it will likely be a less healthy choice than we may strive for in our day-to-day life.

In terms of tone, parents were no different from the other groups – they preferred positive and encouraging messages. A good example of one such message is, “Make time for healthy eating so that children don't feel rushed. Set regular times for meals and snacks. This helps to establish a healthy routine.” Messages that imply bad, or less than ideal parenting, come across as condescending and should be avoided. Parents did not react well to the following: “You have the power to change a habit! Be a role model for your family by limiting sugary drinks in your home.” Participants reacted negatively to the line about being a role model for their family, as it implied they were not currently modelling good behaviour for their children. Parents appreciate suggestions that can help them improve without simply reminding them they are failing.

Teachable moments and ways to encourage healthy behaviour are great examples of “how to eat” messages that resonated with parents. They appreciated specific information in these types of messages. For example, “On the weekend, plan school lunches with your kids for the week ahead. Kids who help make and pack their lunches are more likely to eat and enjoy their food.” They also felt the following piece of advice was an important lesson for their children to learn: “Some products with "vegetable" and "fruit" in their names or on their packaging contain high amounts of sodium or sugars. Fruit candies, vegetable chips, fruit spreads, and vegetable or fruit drinks do not provide the same benefits as whole fruits and vegetables.” Positioning the family as more important than the food makes the most sense when it involves some sort of teachable moment or family activity, such as in the suggestion, “Create a cookbook of favourite family recipes as a gift for someone starting out on their own. It’s a great way to pass along food traditions.”

Of note, participants needed a rationale when a specific, but counter-intuitive suggestion was presented. For example, participants appreciated that the following statement explained what juice or syrup could be replaced with: “Canned fruit can be a great option for school lunches. Make sure that it’s packed in water rather than juice or syrup.” Furthermore, they felt some specific messages did not go far enough. One example was, “Need some ideas for protein options for lunch? Try hard boiled eggs, edamame, Greek yogurt or tuna. Add a grain and vegetable to make it a meal.” Participants wanted to know what kind of grain would be best in this case.

Other Topics of Interest
As a final wrap-up, participants’ were asked whether there were other topics around healthy eating that would be of interest or helpful.

While participants were comfortable with the topics that were presented to them, it was interesting to note that there were two key topics that were suggested in every group:

• Advice related to fueling your body for sport/exercise. Given the inter-relatedness of food and exercise, and the increased participation of Canadians in physical activities, participants in every group suggested advice on how to properly fuel the body before and after physical activity, tips for healthy snacks, what to eat, etc.
• Eating healthy on a budget. Many had the sense that the cost to eat healthy has been rising and is becoming prohibitive. Participants would appreciate advice about how to economize, how to use less expensive ingredients to make nutritious meals, recipes tied to different foods on sale at the grocery store, etc.

The only other topic that was raised in multiple groups was advice around eating healthy while travelling (e.g. road trips). Not to be confused with eating healthy while on vacation, which like Celebrations and Eating out, many participants linked to a time for indulgence rather than sacrifice.

Phase 2

Except where specifically identified, the findings in this qualitative report represent the combined results for both English and French. These findings are discussed in two sections. The first section explores reactions to the draft look-and-feel elements. The second section explores specific reactions to the draft visual elements.

REACTIONS: LOOK-AND-FEEL ELEMENTS
The focus groups began with an exploration of three draft look-and-feel concepts. Each of these look-and-feels was displayed in four different formats: post in a social media news feed, bookmark, and two web buttons of two different sizes. For the purposes of this report, the initial overarching reactions to the three look-and-feel concepts will be discussed in turn based on the post in a social media news feed (as was done in the focus groups), followed by any differences based on the different formats.

Overall Reactions to the Look-and-feel Elements
For each of the various formats, participants were shown all three look-and-feel concepts at once on screen.

While none of the look-and-feel concepts were loved by everyone in their entirety, of the three look-and-feels tested, most participants, across all audiences (health professionals, educators and members of the general public), tended to gravitate toward Concept B. It was the look-and-feel concept that was most often described as being warm, friendly, relatable, positive, interesting, and attention-grabbing.  It was also the one that those inclined to share on social media, would share.

With respect to the tagline, many were confused as to how it related to Canada’s Food Guide. While some could connect the tagline to some of the look-and-feel elements (illustrations), the tie to Canada’s Food Guide was not obvious to most. When asked, typically one or two participants in every group could explain that they believed it related to eating healthy where you live, learn, work and play. As we will see later in this report, understanding and views of the tagline did improve when participants were shown the visual elements.

For reporting purposes, Concept B will be discussed first for each format given the generally more favourable reactions to this look-and-feel concept overall.

Participants described this look-and-feel concept as being representative of Canada, of people living in urban and rural settings, and a depiction of food from farm to table. All three look-and-feel concepts, this was the one that most obviously linked to food given the depictions of trees and farm land which were illustrative of where food comes from.

There was generally a positive feeling conjured up by the illustration. Participants really liked seeing the mountains, forests, and farmlands of Canada. Even the Canadian flag on the school was noticed and appreciated.

Worth noting, primary and community level educators both felt that the illustration would capture the attention of their primary audience: young children. They felt that they could use the illustration as an educational tool, when discussing Canada’s Food Guide, to show children where food comes from and how it gets to our tables.

When asked to suggest how the current illustration could be improved, participants suggested inclusion of:

• More obvious references to food (i.e., apples or cherries in the trees and/or animals and vegetables in the farm field).
• A depiction of water, and preferably a coast line, to represent those in coastal regions. This was particularly relevant for participants in St. John’s.
• More obvious reference to Canada’s Indigenous people (although some Indigenous participants saw themselves represented in the forests and mountains). When asked how Indigenous people could be more obviously represented, there was a suggestion to include an eagle flying in the sky or a totem pole.
• A market or grocery store to illustrate where people usually buy food.
• A garden (or community garden), which was depicted in one of the visual concepts, and will be discussed later in this report.

Finally, when asked, most felt that this concept came the closest to connecting Canada’s Food Guide to the tagline. They explained that the trees and farm land depicted where food comes from, which relates to Canada’s Food Guide, and where food will be consumed, in reference to the tagline, where they live (townhomes), learn (school), work (office buildings), and play (playground, basketball court).

Overall, reactions to Concept A were not all that favourable. The green colour was described as eye-catching, but not in a positive way. Participants found the lime green colour to be a little jarring and said they had difficulty reading the white font against the green background; particularly the tagline in the smaller font.

Most were generally confused by this look-and-feel concept. The majority questioned how it related to Canada’s Food Guide, and, food for that matter. The only impression participants could conjure up was that the Food Guide was for urban dwellers.

In terms of the overall look, this was felt to be amateur. Participants felt the illustration looked like clip art and the images used looked outdated. For example, some were confused about the school suggesting it did not look like modern schools and more closely resembled a church given the bell in the tower.

Reactions to Concept C were also not all that favourable. It was most often described as boring, cold, and “typical government”. Most felt that if they came across (i.e., in the mail, in a doctor’s office, etc.), Canada’s Food Guide with this as the cover, they would not be inclined to pick it up and read it.

More importantly, of the three look-and-feel concepts tested, this one was the weakest in terms of linking to food in any way or the tagline.

Impressions of the three look-and-feel concepts did not change all that much based on this format although there were some improved impressions related to Concept B. Worth noting, participants indicated they would be likely to notice Concept B or C on a website.

Reactions to Concept B improved somewhat with the introduction of the body of water (although it was described as a lake rather than a coast). Some felt that important visual elements such as the farm land and forest were cut off. They suggested this bookmark could be improved if the illustration was shifted up to take up a larger proportion of the rectangular shape and, more importantly, make the parts of the illustration that were cut off, visible.

There were some notable differences in reactions to the three look-and-feel concepts based on this format. Worth noting, participants indicated they would be likely to click on Concept B and Concept C.

Impressions of Concept B improved somewhat given some important changes to the illustration: first, and perhaps most importantly, the two bodies of water on either side of the illustration are at the outer edges and cut off giving the impression that these represent Canada’s coastal regions; second, the trees and farm land are more visible in this format than they were in the previous bookmark.

However, some questioned the need for the blue box at the bottom of the button. While it was evident, the box was meant to showcase the website address, participants questioned the need to display the website address given this was a web button upon which people could click to link to more information. In fact, this was consistent across all three concepts, regardless of the blue or white background. Assuming it must be displayed, participants suggested a white background with black font, as the blue background inferred water which did not fit into the illustration and made it harder to delineate the image from the box.

Impressions of Concept A tended to diminish based on this web button. More than before, the illustrations of the four buildings were described as amateur and clip art given the four buildings were apart from one another. However, participants were much more apt to link the illustration to the tagline when the buildings were displayed this way. They explained that they better understood that each building represented where you live, learn, work and play.

Impressions of Concept C were a little more favourable in this format. Some participants remarked that the simplicity of this look-and-feel concept suited the format of a web button. Many commented that this concept would likely capture their attention because it would distinguish itself from the clutter of a web page; they indicated it looked like a button and they would likely click on it.

There were some notable differences in reactions to the three look-and-feel concepts based on this format. Worth noting, participants indicated they would be likely to click on Concept B.

In terms of the proportion of illustration and text, participants felt this format of Concept B got the closest in terms of displaying what they would like to see most prominently: trees/forest, water (on the edge to represent coast lines), farm lands, urban settings and city skylines, and mountains. However, some participants questioned the need for a city skyline on both edges of the illustration and wondered if that space could be used for some of the other visuals they suggested (as reported earlier).

Again, there were questions about the need to display the website address and the decision to display that address in a blue box that resembled water. There was a preference to remove that element, change the blue box to white, or display the website address in a rectangular call-out as illustrated in Concept A.

Impressions of Concept A did not change although, as mentioned, participants did like the rectangular call-out on the bottom left and suggested that look could be applied to the other concepts to display the website address.

Impressions of Concept C were not as favourable in this format as they were in the previous web button. This web button was more rectangular than square and looked less like a button which is what participants appreciated about the format of the previous version. Reactions to this format were more in line to previous in that this was boring, not related to Canada’s Food Guide, and easily overlooked.

REACTIONS: VISUAL ELEMENTS
Following the discussion of the draft look-and-feel elements, the focus group discussions turned to an exploration of two draft visual concepts of the “at-a-glance” graphic. The purpose of the “at-a-glance” graphic is to translate healthy eating policy into plain language. Participants were asked to first review the digital version using their laptop or tablet (for health professionals and educators) and smartphones (for members of the general public), followed by the printed versions of both concepts.

For the purposes of reporting, reactions will be provided based on both the digital and print versions except where differences are noted.

Overall Reactions to the Visual Elements

Overall reaction to the digital and print versions of both concepts was generally positive, although some participants were a little underwhelmed (particularly dietitians in Quebec City and some members of the general public with adequate health literacy).

In large part, this sense of underwhelming was in reaction to the digital concept which seemed to have two important weaknesses: the lack of interactivity and use of icons rather than real photos/images. The compounded effect of the two suggested a product of amateur quality and not a significant departure from the current Food Guide. Worth noting, however, that impressions tended to improve when participants were shown the printed version of the “at-a-glance” concept because all the information was visible at a glance on one page, as opposed to the digital experience which required scrolling to get the full picture. Impressions of the digital experience improved once participants were told that the intention was to create an interactive experience.

With respect to the general population health literacy groups, the differences between the two were very interesting. Those with adequate health literacy felt the concepts were simple. Some felt they were too simple; others described them as simple but not simplistic. Some of those at risk of marginal health literacy, particularly those in Whitehorse, were not all that interested or engaged and did not feel they would be particularly motivated to do anything if they were provided with this information. While it was not stated, there was a sense that they knew all that they needed to know about eating healthy and were comfortable with the choices they are currently making. All things considered, most came away with the sense that this was a good entry point to more information. Indeed, all participants indicated that they wanted more information.

Generally, the majority of participants felt that both a digital and print version would be useful. Health professionals and educators would use the digital concept to discuss healthy eating with their target audiences, tack a printed version up on their classroom or office walls, and then send a printed version home to put up on the fridge. Members of the general public felt they would use the digital version when they were shopping or preparing their grocery lists, and tack a printed version up on their fridges. Indeed, most participants, came away feeling these visual elements were a good entry point to more information; and, most could see themselves interacting with the digital version to learn more about how they could eat healthier.

The element that tended to grab most participants’ attention, and to which reactions were most positive, was the new information that encouraged healthy eating behaviours (i.e., cook more often, eat with others, be mindful of your eating habits, etc.). Participants, from all audiences, shared the merits of this advice and appreciated that it was featured so prominently (first box on the digital version and top left box in the printed version).

In terms of overall look and feel, participants generally seemed to coalesce around Visual Concept B. This preference was often crystallized when participants were shown the printed version. The main factors influencing this preference were:

• The overall professional quality of the visual concept in that it looked like a complete product;
• In large part this was related to the degree to which the illustration tied together with the tagline and the depiction of food (as represented in the trees and farm land).
• The additional food icons and the perceived size increase of the food icons;
• The clarity of the black text against the blue background. Indeed, participants noticed more readily the messaging and headlines in Concept B, even though they were identical in Concept A (apart from the font and background colours).

In terms of the presentation/order of information, preferences were mixed but most tended to prefer the order of Visual Concept B. They suggested that this order allowed them to very quickly get information about how to eat and what to eat, which they felt was a positive start, followed by information about what to limit. Those who preferred the order of Visual Concept A preferred to understand how to eat and what to limit, and then equipped with that information, they could move to what to eat. Worth noting, when presented with the printed version, almost all participants tended to prefer the order of Concept 2, with suggestions for some minor adjustments to the icons in the what to limit section.

Finally, on an unprompted basis, most participants were not inferring much in the way of proportionality either from the visual elements or the messaging. When asked, some could delineate that because vegetables/fruits occupied a larger space visually, or in the example of Visual Concept B that vegetables/fruits were displayed at the top, that most of the food they should consume should come from this category. Others (but not many) inferred from the messaging, “plenty of vegetables and fruit”, that much of what they eat in a day should be vegetables/fruit. However, all of this was not obvious and most indicated that they would have preferred a more direct reference to either specific proportions or, at a minimum, an image of a plate or a pyramid, in which the appropriate proportions of vegetables/fruits, grains, and protein were illustrated.

Specific Reactions to the Icons

There was a lot of confusion, generally, about many of the symbols/icons used throughout. As mentioned earlier, many participants felt that, particularly where the digital concept was concerned, it would be important to use real photos as opposed to icons/symbols. Participants could easily conjure up in their minds images of lush, colourful, appetizing foods that they felt would more effectively communicate all of the enjoyable healthy food choices people could make. This was particularly true of participants in Quebec City (both members of the general public and health professionals/educators) who felt strongly that the symbols should be real photos rather than icons, especially for the digital version of the concepts. Interestingly, these views softened somewhat when presented with the print versions of the Concepts.

Having said this, while most participants were disappointed with the quality of the icons, participants understood that the icons were mainly to depict foods they could consider within the relevant category, rather than specific directives about exactly which foods to eat. The general consensus was that the quality of the icons should be improved.

The icons that seemed most in need of improvement:

• Those used in the advice about “how to eat” were often deemed sterile and impersonal.
  • Be mindful of your eating habits: Some thought the cloud bubble was a little confusing arguing that it reminded them of a weather forecast.
  • Cook more often: Participants argued that a more interesting icon could be used than a cauldron with the suggestion of a silhouette of a person wearing a chef’s hat holding easily identifiable kitchen utensils.
  • Eat meals with others: Participants did not feel the icon effectively communicated the intended concept. There often tended to be one or two participants in each group that suggested adding silhouettes of people to these icons (i.e., showing people sitting around the table, cooking together, etc.). Further, many saw the table cloth as a flag. Some though the table cloth was lavish.
  • A number of participants also felt the glass of water might be better represented with a pitcher of water; and, many recommended adjusting the colouring to make the contrast of the water and blue background of Concept B more obvious.
• Many of the food icons in the “what to eat” section, including the: squash, bagged lettuce, frozen berries, wild rice, oats, quinoa, brown rice, whole grain pita bread, tofu, peas, lentils, and the pork chop.
• The icons used for the message “be aware of food marketing,” which most were not sure properly represented that message. When asked what would be a better representation, participants were hard-pressed to make any suggestions.

The inclusion of canned and frozen goods, was met with mixed reaction. Those in favour argued that it was important to include more economical and time-saving food options. Those in opposition argued that they could be confused for or lead Canadians to make unhealthy choices (i.e., processed foods) but also that the depiction of packaged foods promotes the use of packaging that was not necessarily deemed environmentally-conscious.

With respect to the milk carton icon, while some participants felt this referred to cow’s milk, most felt it symbolized milk products (including soy, almond, coconut, etc.) more broadly.

In terms of the key icon differences between Visual Concept A and Visual Concept B:

• Limit foods high in sodium, sugars or saturated fat – reactions to the food icons versus the food label were mixed. First, participants were curious about the label. Some of the health professionals were aware of the new label but most did not generally recognize it.

  Those who preferred the label liked the idea of educating the public to look for that label on food products. They also appreciated the importance conveyed in the label particularly around the big, bold, exclamation point. They also argued that showing foods people should not eat, but generally really like (i.e., pizza, muffins, etc.), might entice them to make unhealthy choices.

  Those who preferred to see the food icons, argued that they did not pay much attention to the label and probably would not notice it on food products. They felt the other icons were easily recognized and understood and conveyed the message more clearly.

  A number of participants suggested that perhaps a combination of both could be used: icons of foods one should limit with the label (and foreboding exclamation mark).

  On the icon of the pizza, most interpreted it as a representation of take-out pizza, first and foremost, but also felt it represented frozen pizzas as well.

• Use food labels – reactions to the icon used to represent food labels, was understood in both concepts. Some felt that showing the label appropriately called attention to the label; although most feel the icon could be improved (i.e., clarify the font so that it is legible even if it just the title). Others preferred seeing the label on the jar to serve as an education tool for Canadians to consult the labels on food products.
• The inclusion of eggs – participants noticed and appreciated the icon symbolizing eggs in Visual Concept B. This was particularly appealing for health professionals working with those on a budget and is in line with what they recommend as an economical but healthy food option.

Specific Reactions to the Tagline

Reactions to the tagline were slightly improved when reviewing the Visual Elements (versus the Look-and-feel Elements), although participants generally still had difficulties understanding the relation between the two until they were prompted and/or another participant explained what they thought the relationship was. Participants often remarked that the instruction to “Use Canada’s Food Guide where YOU live, learn, work and play,” better explained the tagline as it referred directly to the “use of CFG” and made it much more understandable and relevant. Participants often remarked that they now better understood the intent of the tagline (as opposed to the look-and-feel elements where it seemed to be a source of much confusion). And, while, this tagline was more understandable, some felt it could be a little more interesting, suggesting: “Healthy choices for where you live, learn, work and play” or “Healthy eating for where you live, learn, work and play”.

Phase 1

Overall reaction to the messages was generally quite positive. Participants across all audiences suggested that they preferred positive and friendly messages that presented the advice as a suggestion over negative, condescending, and imperative messages.

With respect to the sample messages tested, the advice offered was deemed useful and practical. The majority felt the messages contained important tips to encourage healthy eating, though for most the information was not new. Many participants would take action as a result of something they read in one of the sample messages, from a change in their own behaviours to changing behaviours that might affect others living in the household, including their children.

The language was clear and easy to understand, though wordy and repetitive or redundant in some cases. Participants preferred short, concise messages, unless they included specific advice, particularly for those with minimal experience in food preparation and youth. These two audiences tended to prefer specific messages, arguing that the non-specific messages were not prescriptive enough.

Reaction towards messages about what and how to eat was mixed, though the findings suggest there is room for both in the communications. Those experienced in food preparation felt information about how, rather than what, to eat was new. Those with minimal experience in food preparation tended to prefer advice about what to eat and why (rationale). The rationale, many participants from both groups argued, provides the “why” and fit with their preference for suggestive over imperative messages.

There was some confusion related to a few topic titles, including Beginner Cook and Celebrations. The Beginner Cook title was confusing (in English) to adults with minimal experience with food preparation, none of whom felt they were beginners. Participants felt the term Celebrations meant family holiday celebrations (i.e., Thanksgiving, Christmas, etc.) and were offended by the suggestion that they should modify traditional meals they eat infrequently. Provided with context, their reactions were more positive. Ensuring the titles capture the spirit of the messages appeared to be important to securing acceptance.

While not a source of confusion, youth and parents had a similar reaction to the topic of Eating Out. They inferred that Eating Out meant going to a sit-down restaurant, rather than getting a coffee or a sandwich at a cafeteria. They also felt Eating Out, was an infrequent occurrence and a time for indulgence, not sacrifice.

Youth appreciated the topic of Eating on the Go because it included useful ideas for quick snacks when they are rushed. That said, the topic heading, Eating on the Go, was not a term they would use, whereas something to do with “snacks” would signal to them that the content was relevant.

Other topic areas upon which participants would welcome healthy eating advice included advice related to Fueling Your Body for Sport/Exercise, Eating Healthy on a Budget and Eating Healthy While Travelling (e.g. road trips).

Phase 2

Overall, the majority of participants preferred Concept B, the light blue concept with the illustration of the tagline, for look-and-feeling purposes. Of all three look-and-feel concepts, Concept B was the one that most closely linked to food and most often described as warm, friendly, relatable, positive, interesting, and attention-grabbing. The illustration best described Canada, as it included people in urban and rural areas, and showed food from farm to table.

In contrast, Concept A, the green concept, was eye-catching, but disliked. Participants found the green unappealing and jarring; it was described as amateur and only depicted Canadians in urban settings.

Participants found Concept C, the plain blue concept, bland and “typical government”. They did not link it to food or the tagline and very few, if any, would be likely to read the guide based on the look-and-feel elements. However, some felt that it was the more modern of the three look-and-feel concepts. Participants felt this concept could translate well to social media because of its simplicity.

Reaction to the digital and print versions of both concepts was generally positive albeit slightly underwhelming, particularly for health professionals. While both versions were deemed useful by most participants, health professionals felt the digital concept was amateur. They disliked that it included icons rather than real photos and lacked interactivity, though impressions improved slightly when provided with that information.

In terms of overall look and feel, consensus emerged around Visual Concept B (the blue background), particularly when participants were shown the printed version. In their view, it was more professional, tied together with the tagline and food, included an appropriate number and proportion of food icons and the text was clearer. Some also preferred the presentation/order of information in Visual Concept B because it allowed them to very quickly get information about how to eat and what to eat, followed by information about what to limit. Those who favoured the order of Visual Concept A preferred to understand how to eat and what to limit, before moving on to what to eat.

Overall, participants felt the icons needed improvement. Further clarification around the design and inclusion of some icons, in addition to information about proportionality, may be warranted to ensure they communicate the intended concept. There was a lot of confusion among respondents about several icons, including most tied to the messages about how to eat as well as food icons.

Participants did not always clearly identify the relationship between the tagline and look-and-feel elements. The instruction to “Use Canada’s Food Guide where YOU live, learn, work and play,” was more effective at connecting the two elements as it referred directly to the “use of CFG”.

Finally, most participants did not take away much information related to proportionality (unprompted). When asked, some concluded that because vegetables/fruits occupy a larger space visually, or in the example of Concept B that vegetables/fruits were displayed at the top, they should eat more of these foods. Most would have preferred a more direct reference to either specific proportions or an image illustrating proportions.

Appendix A: Phase 1

Wrap-up – 10 min

• Over the course of our discussion we explored healthy eating messages around [insert relevant three topics depending on the audience]. I’m curious to know whether there are any other tasks or settings you find yourself in (such as managing picky eaters or food allergies, reading food labels, eating during a specific holiday or event, etc.) that you would appreciate similar guidance on?
  • Is yes, which ones? Why do you say that?
  • Would anyone else find that kind of advice/guidance helpful? Why or why not?

• This concludes what we needed to cover tonight. We really appreciate you taking the time to come down here to share your views. Your input is very important.
• Reminder to those in the first and second groups about reserving comments so as not to influence the next group.

MESSAGES

Adults experienced in food preparation

Healthy eating at work

• Are you in charge of providing snacks for the next meeting? Serve whole wheat pita bread with hummus instead of doughnuts or cookies.
• At the cafeteria, choose an apple, orange or fruit salad rather than a pastry or piece of pie.
• Replace French fries with a side salad and have the dressing on the side when you order a meal from the cafeteria.
• Plan to have healthy snacks on hand so you can skip the vending machine. Chop extra vegetables or make your own trail mix to bring along.
• Sandwiches made with deli meats are often high in sodium and saturated fat. If you eat deli meats, choose lower-fat and sodium-reduced varieties when available.
• Is grabbing a specialty coffee a part of your daily routine? Remember, syrups, toppings and whipped cream can contain high amounts of sugars and saturated fat. Keep it simple, order a coffee with a dash of cinnamon or cocoa powder.
• Do you find yourself snacking a lot at work? This could be because of boredom or stress. Try taking a brisk walk instead.
• Eating with your colleagues can be a great way to share recipes and learn about new foods.
• Take time to eat at work. When you eat at your desk you tend to eat quickly without paying attention to how much you’ve eaten.
• Sharing food can help us learn about other cultures. Try hosting a pot luck where everyone brings a traditional dish and recipe from their family background.
• Cook extra meals and freeze them in individual containers for a home cooked lunch even on days when life is too busy. Just thaw, heat and eat.

Grocery shopping

• Frozen vegetables and fruit are a healthy and convenient choice. Choose frozen vegetables that don’t contain added salty seasonings or sauces. Choose frozen fruit that are not sweetened with added sugars or syrup.
• Think “lean” when choosing meat cuts such as inside round roast, sirloin steak and ground meat or ground poultry.
• Look at the ingredient list rather than the colour of the product to select whole grain foods. Whole grain foods will have the words "whole grain" listed as one of the first ingredients. For example, whole grain oats.
• Got a busy week? Save time with ready-to-use produce like bagged green salad and pre-cut vegetables and fruit.
• Stock up on healthy convenience foods to help make meals in minutes. Low-sodium canned beans and diced tomatoes, water packed tuna and quick cooking grains such as quinoa or whole wheat pasta are all time-savers.
• Successful grocery shopping starts with a plan. Write down your meal and snack ideas on a piece of paper, a meal planner or your cell phone.
• Eat before you shop. You're more likely to make impulse purchases when you are hungry.
• See a low-cost lean cut of meat but unsure how to cook it? The internet can be a great source of information.
• Be a savvy shopper and look beyond the packaging. Food labels help you make an informed decision. Use the labels to compare between products.
• Many grocery stores offer pre-mixed sauces and seasonings to help you recreate complex dishes from your culture. They can be convenient but watch out for sodium, sugars and saturated fat. Read the food labels and compare a few products to find the healthiest option.

Eating on the go

• When choosing cereals and granola bars, look for ones that have more fibre and less sugar, and list whole grains as the first ingredient.
• Keep cut up vegetables in the fridge, or a bowl of fruit on the counter for a quick and healthy snack.
• Dry roasted nuts and seeds without added oils or salt make a healthy protein-rich snack. You can also toss them into salads for an added crunch.
• Keep a refillable bottle of water handy. Don’t leave home without it filled. You’ll always have a healthy convenient drink on hand.
• Coffee shop muffins or bagels may seem like a good choice when you’re on the go. However, they’re often loaded with sodium, sugars and saturated fat. Plan ahead and pack your own healthy snack.
• Spread your meals throughout the day to keep you satisfied. If you’re pressed for time, avoid skipping meals which may cause you to eat more than you need later in the day.
• Include healthy snacks when planning your meals and add them to your grocery list. What you keep in your cupboards and fridge is what you'll snack on!
• Foods marketed as healthy snacks may still be high in sodium, sugars or saturated fat. Read the food labels when choosing and comparing foods.

Adults with minimal experience in food preparation

Healthy eating at home

• Whole grains are wholesome! Enjoy a wide variety each day. Whole grains include whole wheat pasta, barley, brown or wild rice, oats, buckwheat, rye and flax.
• Trim visible fat from meat and skin from poultry before cooking. Drain off extra fat after cooking.
• Cook with little or no salt. Use less salt than what a recipe calls for and taste your food before adding more.
• Be a role model for your friends and family. Make water your drink of choice and they will too.
• Stock your freezer with a few kinds of frozen vegetables and fruits such as peas and carrots, spinach, strawberries and blueberries. You’ll always have them on hand to cook and enjoy.
• Instead of buying iced tea, which can be high in sugars, make your own at home. Add ginger, cinnamon sticks, fresh mint or lemon for flavour instead of sugar.
• Avoid snacking when you are reading, working or watching TV. You are likely to eat more if you are distracted. 
• Vegetables and fruit don't have to take long to prepare. Take some time to prepare for the week ahead. Washed carrots, cucumbers, cherry tomatoes, apples and oranges make good grab-and-go snacks!
• Have beans and lentils often. They’re high in protein and fibre, and are low in saturated fat.
• Think about the favourite family meals you grew up eating and continue to make today. Are there ways to make them healthier? Try adding more vegetables, or using whole grains and reduced fat dairy products. Experiment to see what you like best.

Beginner cook

• Look for the word “whole” at the beginning of the ingredient list on packaged grains. Ingredients listed as “multi-grain” or “100% wheat” are not necessarily whole grain.
• Try reducing the amount of salt recipes call for when cooking. Experiment with fresh or dried herbs to boost the flavour.
• Eggs can be good for dinner. Prepare them poached, scrambled or made into an omelette with any vegetables in your fridge for an easy supper.
• Use a small amount of vegetable oil for stir-frying or sautéing. A teaspoon is usually enough. You can heat the oil before frying to prevent the food from soaking up the oil.
• Instead of sugary drinks, try refreshing sparkling water made with cucumber slices or limes.
• Try at least one new vegetable or fruit each week.
• Convenience foods save time but they can also be loaded with sodium, sugars or saturated fat. Use the food labels to help you make healthier choices.
• Enjoy eating and trying new recipes with family and friends.
• If you’re new to cooking, start simple. Focus on learning one technique at a time. Once you’re feeling comfortable, try something new. It’ll become easier as you go.
• Plan ahead and make a list of the foods you need when grocery shopping.

Celebrations

• Take time to eat and enjoy your food. Start with small portions and eat slowly. Take a break before reaching for seconds.
• Cut your chance of overeating at special events by eating regularly during the day. No skipping meals. Curb your hunger before an event with a small, healthy snack an hour before you go out.
• In charge of dessert? Serve small portions of rich sweets beside a platter of seasonal fruit such as clementines, strawberries or melon.
• Make stuffing using whole grain bread, wild rice or quinoa, instead of white bread.
• Use herbs and fresh salsas instead of salt to season and flavour fish, meats and poultry.
• Offer to bring a dish. Take a vegetable or fruit platter, bean dip with whole grain pita wedges, or tomato and black bean salsa with baked tortilla chips.
• If you choose to drink alcohol, alternate alcoholic drinks with other options such as sparkling water with lime or low-sodium vegetable juice.
• Celebrate special events with family and friends. It's a great way to pass along cooking skills and learn about traditional or cultural foods.
• Have healthy snacks on hand, like pre-cut vegetables and fruit. It's easy to grab while you're rushing from one holiday gathering to the next.
• Are there special foods you only eat during the holidays? Enjoy these foods and skip others like chips and chocolate that you can get any time.

Seniors responsible for food preparation

Building healthy meals & snacks

• Make your own soup or buy lower sodium canned soups when possible. Look for the words "low sodium," "reduced sodium" or "no added salt" on the package.
• Drink water with your meals. Keep a pitcher on the table for easy access.
• Eat protein foods, such as lentils or tofu, that come from plants. If you aren’t used to cooking with them, try going online to learn new recipes and cooking methods.
• Even though they don’t taste salty, some grain products such as tortillas, bagels and bread can contain high amounts of sodium. Look for sodium-reduced products or compare nutrition labels to find those with the lowest amount of sodium.
• Enjoy fish such as salmon, mackerel, sardines, char, trout and herring. Get the benefits of healthy fats.
• Ask yourself if you are really hungry when you are looking in the fridge for a bite to eat. Stress or boredom can trigger the urge to snack.
• There's no right or wrong way to plan meals. Some people like to plan for the whole week while others plan for a couple of days. Do what works for you.
• Recipes and food traditions are a part of family history. Share family food traditions with younger generations.
• Buy canned or frozen vegetables and fruits. You don’t need to clean or chop them.
• Different vegetables and fruits offer different nutrients. Include a variety in your diet for health.

Eating on a budget

• Plan healthy meals and snacks by writing out a grocery list before going to the store. Save money by sticking to your list. Cut down on impulse buys.
• Flip through grocery store flyers to find specials and use coupons to save money. Don’t forget to see if your local grocery stores offer discount days for seniors. Plan to shop on that day.
• Drain and rinse canned vegetables to lower the sodium content.
• Eat meatless meals more often! Instead of meat have baked beans, lentil chilli or an egg sandwich. They cost less.
• Whole grain products generally freeze well. Freeze leftover bagels, tortillas or bread instead of throwing them out.
• Consider skim milk powder. It can be cheaper and easier to store than regular milk, and added to cream soups, hot cereals or stews.
• Water is often the cheapest option. Make water your drink of choice and avoid the extra costs of other beverages.
• Processed foods and drinks that are high in sodium, sugars or saturated fat are often expensive and offer little nutrition. Cutting back on these foods can save you money and can be good for your health. Have foods like chips, chocolate and pop less often and in smaller amounts.
• Fresh, frozen or canned vegetables and fruit are all are healthy options.
• Do you often eat out with family or friends when celebrating special events? Plan and prepare a meal together at home instead.

Healthy eating for seniors

• Enjoy the taste of whole grains. Skip the butter when you are eating breads and rolls.
• Drink water often throughout the day.
• For added fibre, add a spoonful of unprocessed bran or bran cereal to your oatmeal, cereal or yogurt. High fibre foods are good for your digestion.
• Eggs are a very convenient and versatile protein food. Prepare them poached, scrambled or made into an omelette with your favourite chopped vegetables.
• Add less salt when cooking. Flavour foods with lemon, herbs or spices instead of salt.
• Cooking and freezing extra meals is a great way to eat well on those days when you don’t feel like cooking. Just thaw, heat and eat.
• Eating with others can be a great way to add enjoyment to mealtimes. Enjoy the many benefits of eating with family and friends.
• Variety can make food more appealing. Include different kinds of healthy foods in your meals.
• Choose healthy prepared foods to make meals easier. Choose low sodium canned or frozen vegetables and low sodium bottled pasta sauces.
• Choose vegetables and fruits of different textures and colours to fit your taste.

Youth

Eating on the go

• You can save money by carrying a reusable water bottle with you wherever you go. Buying a drink – even water – can add up.
• Do you feel too rushed to eat in the morning? A piece of fruit and a handful of nuts are a quick option to start your day.
• Granola bars are a quick and easy snack. Choose ones with whole grains as the first ingredient and compare the nutrition labels to find those with more fibre and less sugar.
• Beans and lentils are a great source of protein. Try healthy oven roasted chickpeas. Add a dash of olive oil, cumin and chilli powder to a can of drained chickpeas and roast them at 400 °F (200 °C) for 30-40 minutes.
• Snacks like muffins and cookies can be high in sugars and saturated fat. Try swapping them for plain lower fat yogurt with a piece of fruit.
• Prepared and frozen entrees can be tempting because they are convenient. These foods are often high in sodium and saturated fat. Compare the nutrition labels on these products to make informed food choices.
• Do you get hungry at your after school activity? Make a healthy snack that you can bring along.
• Vegetables and fruit are nature’s fast food. Just wash and go!
• Take healthy snacks from home to eat at school or on the go. Reduce your temptation to buy snacks that are high in sodium, sugars and saturated fat.

Building healthy meals & snacks

• Trade your morning cinnamon bun for a whole grain English muffin. The added fibre will help keep you fuller for longer.
• Do you always make your sandwiches with deli meat? Try making your next one with eggs, hummus, natural peanut butter or cooked lean meat instead.
• When cooking, use vegetable oils and soft margarine instead of butter, hard margarine and coconut oil.
• Sauces and condiments can be high in sodium, sugars and saturated fat. Compare the nutrition labels to find the healthier choice.
• Treat your taste buds with water! Add mint, basil, berries, oranges or cucumber slices for a different flavour.
• Have you ever come across a food and not known what it is or how to cook it? Don’t put it down. Go online and find out.
• There are many different vegetables that you can add to your meal. Trying new foods can help you learn about what you like.
• Make mornings easier by planning your meals and snacks the night before.
• Eating together as a family can be good for everyone. Even if your schedule is busy, work together and make it happen.
• You can learn a lot about your culture from food. Grab a family member and get cooking.

Eating out

• Next time a friend asks you to go out to eat, think about whether you’re actually hungry. If not, suggest another fun activity.
• Choose places that have plenty of vegetables and fruits on their menu.
• Order sandwiches, subs or wraps made with whole grain bread, buns or tortillas.
• Choose a grilled or roasted chicken sandwich instead of chicken wings or chicken fingers.
• Eat fewer cakes, cookies and rich desserts. If you are going to order dessert, eat a smaller size or share with your family or friends.
• Choose water instead of pop, juice or energy drinks.
• Say yes to water with your meal. It’s a cost-free thirst quencher.
• Choose baked, broiled or steamed foods instead of breaded or deep-fried foods. Foods that are baked, broiled or steamed tend to be lower in saturated fat.
• Sauces, condiments, dressings and spreads can add sodium, sugars and saturated fat to your meal. Ask for them on the side and use just enough to get some flavour.
• Most people think of eating out as a treat. Try thinking of the time you are spending with friends or family as the treat rather than the food you choose.
• No matter what kind of restaurant you choose, some choices are healthier than others. Ask how items are prepared and if nutrition information is available. This can help you make an informed choice.

Parents responsible for food preparation

Planning & preparing healthy food with the family

• Ask your kids to choose a new whole grain, such as brown rice, barley or quinoa, to make together.
• Swap the family’s morning granola, which can be high in saturated fat, for seeds such as pumpkin, chia or ground flax. They add flavour, crunch and are a source of healthy fats.
• You have the power to change a habit! Be a role model for your family by limiting sugary drinks in your home.
• Make food the main attraction at meal times. Screens such as TVs, cellphones and tablets at the dinner table distract you from eating. They also take away from family conversation which adds to the enjoyment of sharing a meal together.
• Make time for healthy eating so that children don't feel rushed. Set regular times for meals and snacks. This helps to establish a healthy routine.
• Create a cookbook of favourite family recipes as a gift for someone starting out on their own. It’s a great way to pass along food traditions.
• Put a bowl of fruit on the table. It is an easy snack to grab.
• Create a healthy food environment at home. How you shop, cook and eat will shape your family’s attitudes and skills.
• Be patient. If your child rejects a new food the first time, you can offer it again later. The more often children are exposed to new foods the more likely they are to try them.
• Share the tasks. When your kids help with planning and preparing meals, it increases their confidence and ability in the kitchen.
• Teach kids about making healthy food choices at the grocery store. Encourage them to read the food labels on packages.

Packing healthy lunches

• Canned fruit can be a great option for school lunches. Make sure that it’s packed in water rather than juice or syrup.
• Tired of making sandwiches? Sometimes changing something as simple as the type of bread can be helpful. Use whole grain pita, flatbread or tortilla instead.
• Need some ideas for protein options for lunch? Try hard boiled eggs, edamame, Greek yogurt or tuna. Add a grain and vegetable to make it a meal.
• When making sandwiches, think about the sauces and spreads you choose. Choose ones lower in sodium and saturated fats.
• Some products with "vegetable" and "fruit" in their names or on their packaging contain high amounts of sodium or sugars. Fruit candies, vegetable chips, fruit spreads, and vegetable or fruit drinks do not provide the same benefits as whole fruits and vegetables.
• Send your child to school with a refillable water bottle along with their lunch.
• On the weekend, plan school lunches with your kids for the week ahead. Kids who help make and pack their lunches are more likely to eat and enjoy their food.
• Prepare as much of the lunch as you can the night before. Use dinner leftovers to make quick and easy lunches.
• Kids of all ages can help prepare the vegetables and fruits for their lunch. They can wash, peel or chop.

Eating out

• Encourage children to order a small salad or vegetables with their meal and fresh fruit for dessert.
• Make your order healthier by substituting raw or steamed vegetables for French fries.
• Ask for whole grain options such as brown rice, whole grain bread or whole wheat pizza crust for your order.
• Choose a protein that has been baked, broiled, grilled or steamed instead of breaded or deep-fried.
• The sauces and dressings that come with your entrée are often high in sodium, sugars and saturated fat. Ask for them on the side so you can control the amount.
• Satisfy your kids’ thirst with water or milk.
• Plan ahead when choosing a restaurant. Check online menus for nutrition information.
• Some restaurants serve more food than you need. If you are served too much food, ask for a "take-home package" and keep the leftovers in the fridge for the next day.
• Kids menus don’t always have the healthiest choices the restaurant has to offer. Try ordering a healthy appetizer or a few healthy sides to make your own kids meal.

SCREENER

Focus Group Summary

• Recruit 10 participants per group
• Ensure good mix of demographics (gender, age, income, household type, cultural backgrounds, etc.) in all groups

• Group 1: Adults (19+) experienced in food preparation (responsible for grocery shopping and are employed outside the home)
  • Must be 19+ (S3)
  • Must be primarily responsible for grocery shopping (S4)
  • Must be employed (S8) outside the home (S9)
• Group 2: Adults (19+) with minimal experience in food preparation
  • Must be 19+ (S3)
  • Must eat mostly pre-packed or prepared foods (S5)
• Group 3: Seniors (65+) responsible for food preparation
  • Must be 65+ (S3)
  • Must be primarily responsible for food preparation (S4)
  • Ensure good mix of those living with someone else or alone (S6)
  • Must NOT live in an assisted living or long term care facility (S7)
• Group 4: Youth (16-18)
  • Must be 16 to 18 years of age, ensure good mix (S3)
  • Must live with parent/caregiver (S13)
• Group 5: Parents (of children 2 to 16) responsible for food preparation
  • Must be 19+ (S3)
  • Must be primarily responsible for grocery shopping AND meal preparation (S4)
  • Must be a parent/caregiver of a child between 2-16 who live with them in the home (S8)

Focus Group Dates	Time
OTTAWA Tuesday, March 20, 2018	Honorarium: $100
Group 1: Adults (19+) responsible for grocery shopping	5:30 pm
Group 2: Adults (19+) with minimal experience in food preparation	7:30 pm
OTTAWA Wednesday, March 21, 2018	Honorarium: $100
Group 3: Seniors responsible for food preparation	3:00 pm
Group 4: Youth (16-18)	5:30 pm
Group 5: Parents of children (2-16)	7:30 pm
QUEBEC CITY Wednesday, March 21, 2018	Honorarium: $100
Group 1: Adults (19+) responsible for grocery shopping	5:30 pm
Group 2: Adults (19+) with minimal experience in food preparation	7:30 pm
QUEBEC CITY Thursday, March 22, 2018	Honorarium: $100
Group 3: Seniors responsible for food preparation	3:00 pm
Group 4: Youth (16-18)	5:30 pm
Group 5: Parents of children (2-16)	7:30 pm

• Respondent’s name:
• Respondent’s phone number: (home)
• Respondent’s phone number: (work)
• Respondent’s fax number:
• Respondent’s email:
• Sample source: panel random client referral
• Interviewer:
• Date:
• Validated:
• Quality Central:
• On list:
• On quotas:

S1.	Do you or any member of your household currently work for or have you or has any member of your household ever worked for…

IF “YES” TO ANY OF THE ABOVE, THANK AND TERMINATE.

S2.	DO NOT ASK – NOTE GENDER

	Male
	Female

ENSURE GOOD MIX OF GENDER

S5.	(FOR THOSE WHO ANSWERED A, B OR C TO S4) On average, out of the meals you eat each week, how many are prepared at home from basic ingredients?

Most meals

Some

Few to none

MUST SAY “FEW TO NONE” TO QUALIFY FOR GROUP 2

S6.	Do you live with someone else?

Yes	1
No	2

ENSURE GOOD MIX FOR GROUP 3

S7.	[IF 65+ ASK] Do you live in an assisted living or some other long term care facility?

Yes	1	THANK AND TERMINATE
No	2

S8.	Are you the parent or caregiver of a child or children between the ages of 2 and 16 years old who live with you?

Yes	1	CONTINUE FOR GROUP 5
No	2

S9.	What is your current employment status?

Working full-time	1	CONTINUE TO S9
Working part-time	2	CONTINUE TO S9
Self-employed	3	CONTINUE TO S9
Retired	4	SKIP TO S10
Unemployed	5	SKIP TO S10
Student	6	SKIP TO S10
Stay at home parent	7	SKIP TO S10
Other (please specify)	8	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S11.	Which of the following categories best describes your total household income? That is, the total income of all persons in your household combined, before taxes [READ LIST]?

Under $20,000	1	ENSURE GOOD MIX OF INCOME
$20,000 to under $40,000	2
$40,000 to under $60,000	3
$60,000 to under $80,000	4
$80,000 to under $100,000	5
$100,000 to under $150,000	6
$150,000 or more	7
DK/NR	9	THANK AND TERMINATE

S12.	What is the last level of education that you have completed?

Elementary school	1	ENSURE GOOD MIX OF EDUCATION
Some high school	2
Completed high school	3
Some college/university	4
Completed college/university	5
Post-graduate studies	6
DK/NR	9	THANK AND TERMINATE

S13.	Which of the following best describes your current household situation? Are you living…?

By yourself	1	ENSURE GOOD MIX OF HOUSEHOLD SITUATION
As a single parent with your children at least some of the time	2
With a partner or spouse	3
With a partner or spouse and your children	4
As a blended family (with a spouse and yours and/or their children)	5
With your parents/caregiver only or with your parents/caregiver and sibling(s)	6
Other (please specify)	7
DK/NR	9	THANK AND TERMINATE

S14.	To make sure that we speak to a diversity of people, could you please tell me what is your ethnic background? DO NOT READ

Caucasian	1	ENSURE GOOD MIX OF ETHNICITY
Chinese	2
South Asian (i.e., East Indian, Pakistani, etc.)	3
Black	4
Filipino	5
Latin America	6
Southeast Asian (i.e. Vietnamese, etc.)	7
Arab	8
West Asian (i.e. Iranian, Afghan, etc.)	9
Korean	10
Japanese	11
Indigenous (First Nations, Métis, or Inuit)	12
Other (please specify)	13
DK/NR	14

AIM FOR AT LEAST 1 INDIGENOUS PERSON IN EVERY GROUP WHEREVER POSSIBLE.

S15.

Have you participated in a discussion or focus group before? A discussion group brings together a few people in order to know their opinion about a given subject. Unlike problem-solving groups, we do not need to reach a consensus. Discussion groups allow us to understand the variety of ideas, opinions, attitudes, and experiences represented by those in attendance.

Yes	1	(MAX 1/3 PER GROUP, ASK S16, S17, S18)
No	2	SKIP TO S19
DK/NR	9	THANK AND TERMINATE

S16.	When was the last time you attended a discussion or focus group?

If within the last 6 months	1	THANK AND TERMINATE
If not within the last 6 months	2	CONTINUE
DK/NR	9	THANK AND TERMINATE

S17.	How many of these sessions have you attended in the last five years?

If 4 or less	1	CONTINUE
If 5 or more	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S18.	And what was/were the main topic(s) of discussion in those groups?

IF RELATED TO FOOD, HEALTHY EATING, NUTRITION/DIET, CANADA’S FOOD GUIDE, THANK AND TERMINATE.

INVITATION

S19.	Participants in discussion groups are asked to voice their opinions and thoughts. How comfortable are you in voicing your opinions in front of others? Are you… (READ LIST)

Very comfortable	1	MINIMUM 4 PER GROUP
Fairly comfortable	2	CONTINUE
Comfortable	3	CONTINUE
Not very comfortable	4	THANK AND TERMINATE
Very comfortable	5	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S20.	Sometimes participants are asked to read text and/or review images during the discussion. Is there any reason why you could not participate?

Yes	1	THANK AND TERMINATE
No	2	CONTINUE
DK/NR	9	THANK AND TERMINATE

S21.

Based on your responses, it looks like you have the profile we are looking for. I would like to invite you to participate in a small group discussion, called a focus group, we are conducting at [TIME], on [DATE]. As you may know, focus groups are used to gather information on a particular subject matter; in this case, the discussion will touch on the food choices you make. The discussion will consist of 8 to 10 people and will be very informal. It will last up to two hours, refreshments will be served and you will receive $100.00 as a thank you for your time. Would you be willing to attend?

Yes	1	RECRUIT
No	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

PRIVACY QUESTIONS
Now I have a few questions that relate to privacy, your personal information and the research process. We will need your consent on a few issues that enable us to conduct our research. As I run through these questions, please feel free to ask me any questions you would like clarified.

P1)

First, we will be providing the hosting facility and session moderator with a list of respondents’ names and profiles (screener responses) so that they can sign you into the group. This information will not be shared with the Government of Canada department organizing this research. Do we have your permission to do this? I assure you it will be kept strictly confidential.

Yes	1	GO TO P2
No	2	READ RESPONDENT INFO BELOW

We need to provide the facility hosting the session and the moderator with the names and background of the people attending the focus group because only the individuals invited are allowed in the session and the facility and moderator must have this information for verification purposes. Please be assured that this information will be kept strictly confidential. GO TO P1A

P1a)	Now that I’ve explained this, do I have your permission to provide your name and profile to the facility?

Yes	1	GO TO P2
No	2	THANK & TERMINATE

P2)

An audio and/or video tape of the group session will be produced for research purposes. The tapes will be used only by the research professional to assist in preparing a report on the research findings and will be destroyed once the report is completed. Do you agree to be audio and/or video taped for research purposes only?

Yes	1	THANK & GO TO P3
No	2	READ RESPONDENT INFO BELOW

It is necessary for the research process for us to audio/video tape the session as the researcher needs this material to complete the report.

P2a)	Now that I’ve explained this, do I have your permission for audio/video taping?

Yes	1	THANK & GO TO P3
No	2	THANK AND TERMINATE

P3)

Each month we submit the names of individuals that have participated in our focus groups to the Marketing Research and Intelligence Association Qualitative Central system (www.mria-arim.ca). Qualitative Central serves as a centralized database to review participation in qualitative research and focus groups. You will not be contacted for any reason whatsoever as a result of being on this list. Do we have your permission to submit your name and phone number to MRIA’s Qualitative Central system?

Yes	1	THANK & GO TO INVITATION
No	2	GO TO P3A

P3a)

To participate in this focus group we must have your permission to add your name to the Qualitative Central system as it is the only way for us to ensure the integrity of the research process and track participation in qualitative research. The system is maintained by the industry body, the Professional Marketing Research Society, and is solely used to track your participation in qualitative research (such as focus groups). You will not be contacted for any reason whatsoever as a result of being on this list. Now that I've explained this do I have your permission to add your name to our qualitative central list?

Yes	1	THANK & GO TO INVITATION
No	2	THANK & TERMINATE

Look-And-Feel (Look And Feel) Testing (Digitally) – T=40 min

The focus of our discussion today/tonight will be on healthy eating. Health Canada is updating Canada’s Food Guide; developing content to be more relevant to Canadians.

• [HANDS UP] How many of you were aware that Canada’s Food Guide is under revision?

They are moving away from an “all-in-one” policy and education tool to a suite of tools and resources aimed at specific target audiences, including health professionals, policy makers and the general public. This will help deliver the right information to the right people in the right format and in the right amount of detail. The new suite of tools will include an “at-a-glace” graphic to help translate healthy eating policy into plain language for the general public.

• I’m curious to know, what type of information do you expect to see on this new Canada’s Food Guide tool (imagine this as a one-page)?

To begin, I would like to show you a series of visuals. I would ask you to focus on the look-and-feel, and, by this I mean, the colours, the font, the symbols/images used, the words, etc. To do so, I would ask that you take out your smartphone and that you click on this link (bit.ly) to see the first visual.

• MATERIALS TO BE TESTED (IN THIS ORDER):
• POST IN A SOCIAL MEDIA NEWS FEED
• BOOKMARK
• CLICKABLE BUTTONS (150X80)
• CLICKABLE BUTTONS (450X100)

MODERATOR TO REVIEW EACH CONCEPT ONE BY ONE (IN THE SAME ORDER IN WHICH THEY WERE PRESENTED).

Concept Testing – T=60 min

For the remainder of our discussion, we will be reviewing 2 concepts of visuals (concept 1 and concept 2). To do so, I would ask that you use your smartphone to click on the following link (bit.ly) to see the first visual.

MODERATOR TO REVIEW THE DIGITAL AND PRINT VERSION OF EACH CONCEPT. CONCEPT 1 AND 2 WILL BE ALTERNATED IN EACH GROUP. DIGITAL EXECUTION OF EACH WILL BE REVIEWED FOLLOWED BY THE PRINT.

Please take a few minutes to read and review it. Feel free to make notes on your notepaper. I would like to understand what you like/what resonates with you, what you don’t like/what doesn’t resonate with you, or whether anything is confusing or unclear.

Please do this on an individual basis in silence. We will discuss your thoughts/comments together as a group in a few minutes.

• In looking at each textual component and icon/symbol:
  • be mindful of your eating habits
  • enjoy your food
  • eat meals with others
  • cook more often
  • limit foods high in sodium, sugars, saturated fat
  • be aware of food marketing
  • use food labels
  • drink water
  • use Canada’s Food Guide where you live, learn, work and play

a)

Do you feel that each graphic icon relates to its associated textual component? [Probe for concept 1 and 2 comparatives]: In concept 1 food examples are depicted of foods to limit (ex: pizza, soda, etc.); whereas concept 2 uses an icon related to the message of foods to limit. Is depicting the foods to limit in the way shown in concept 1 helpful or not? Do you think that showing the foods in this way clearly communicates that these foods are meant to be limited? Why or why not? Which concept achieves this objective best? Why? [Probe for concept 1]: Can you please describe the image of the pizza? What does this represent for you? [MODERATOR: Trying to verify whether the pizza looks like it is from a frozen entrée rather than order out pizza] [Probe for concept 1 and 2 comparatives]: Concept 1 depicts ‘Use food labels’ with a label on a jar. Concept 2 depicts ‘Use food labels’ with a sample label. Which concept is clearer to understand?

b)	In looking at the icon and textual message together, what do you think the icon and message is intending to communicate as it relates to healthy eating?

c)

In looking at the food icons and the associated messages (eat a variety of healthy foods: plenty of vegetables and fruit, whole grain foods, and protein foods): Do any of the foods depicted surprise you? Which ones? why? Do you think the foods shown are simply examples of foods to represent the broader category of foods? OR Do you think they are meant to say you should be eating only these foods each day? Why or why not? Do you get the sense that the majority of the foods that are recommended for healthy eating are those that come from plants AND that healthy eating may also include foods that are not plants (like: white milk, meat (poultry, pork), fish, etc.)?

d)

Take a look at the placement of ‘vegetables & fruit’ in concept 1 (bottom centre) and concept 2 (top right) as well as the amount of vegetables and fruit depicted in both concepts. Does the placement or the amounts depicted in either concept signal to you a greater importance or do both placements and amounts depicted imply a similar level of importance of vegetables and fruits? Why do you say that?

Look-And-Feel (Look And Feel) Testing (Digitally) – T=40 min

The focus of our discussion today/tonight will be on healthy eating. Health Canada is updating Canada’s Food guide; developing content to be more relevant to Canadians.

• [HANDS UP] How many of you were aware that Canada’s Food Guide is under revision?

They are moving away from an “all-in-one” policy and education tool to a suite of tools and resources aimed at specific target audiences, including health professionals, policy makers and the general public. This will help deliver the right information to the right people in the right format and in the right amount of detail. The new suite of tools will include an “at-a-glace” graphic to help translate healthy eating policy into plain language for the general public.

• I’m curious to know, what type of information do you expect to see on this new Canada’s Food Guide tool (imagine this as a one-page)?

To begin, I would like to show you a series of visuals. I would ask you to focus on the look-and-feel, and, by this I mean, the colours, the font, the symbols/images used, the words, etc. To do so, I would ask that you take out your smartphone and that you click on this link (bit.ly) to see the first visual.

MATERIALS TO BE TESTED (IN THIS ORDER):

• POST IN A SOCIAL MEDIA NEWS FEED
• BOOKMARK
• CLICKABLE BUTTONS (150X80)
• CLICKABLE BUTTONS (450X100)

MODERATOR TO REVIEW EACH CONCEPT ONE BY ONE (IN THE SAME ORDER IN WHICH THEY WERE PRESENTED).

• Overall, what did you think of this concept? Do you like it or not? Why do you say that?
• Does it resonate with you? Do you think it would resonate with your target audience (clients/patients/students)? Why or why not?
• Is it credible to you? Would your audience find it credible? Why or why not?
• As far as you’re concerned, is it modern/current (not outdated)? Do you think your target audience would find it modern? Why or why not?
• [FOR THE BUTTON, MODERATOR TO EXPLAIN:] This is an image that you could find on a website that one could click on and it would lead to the content supporting Canada’s Food Guide.
  • Would you want to use or put this image on your own website? Why or why not?
• [FOR THE SOCIAL MEDIA CONCEPTS] Would you share this with your contacts on social media? Why or why not? If you saw this image in your social media newsfeed, would you click on the link? Why or why not?
• What did you think of the tagline – Use Canada’s Food Guide where you live, learn, work and play?
  • Do you think it would get your target audiences’ attention? Do you think they would to do anything (does it lend one to want to find out more – a call to action? Why or why not?
  • Is it clear? Why or why not?
• Which concept would be most likely to capture your attention? Why?
• Which concept is relatable? Why or why not?
• Which concept is friendly? Why or why not?
• Which concept comes across positive? Why or why not?

Concept Testing – T=60 min

For the remainder of our discussion, we will be reviewing 2 concepts (Concept 1 and Concept 2). To do so, I would ask that you use your laptop tablet to click on the following link (bit.ly) to access the first visual.

MODERATOR TO REVIEW THE DIGITAL AND PRINT VERSION OF EACH CONCEPT. CONCEPTS 1,2 WILL BE ALTERNATED IN EACH GROUP. DIGITAL EXECUTION OF EACH WILL BE REVIEWED FOLLOWED BY THE PRINT.

Please take a few minutes to read and review it. Feel free to make notes on your notepaper. I would like to understand what you like/what resonates with you, what you don’t like/what doesn’t resonate with you, or whether anything is confusing or unclear.

Please do this on an individual basis in silence. We will discuss your thoughts/comments together as a group in a few minutes.

FOR EACH DIGITAL CONCEPT, MODERATOR TO PROBE:

• In looking at each textual component and icon/symbol:
  • be mindful of your eating habits
  • enjoy your food
  • eat meals with others
  • cook more often
  • limit foods high in sodium, sugars, saturated fat
  • be aware of food marketing
  • use food labels
  • drink water
  • use Canada’s Food Guide where you live, learn, work and play

a)

Do you feel that each graphic icon relates to its associated textual component? [Probe for concept 1 and 2 comparatives]: In concept 1 food examples are depicted of foods to limit (ex: pizza, soda, etc.); whereas concept 2 uses an icon related to the message of foods to limit. Is depicting the foods to limit in the way shown in concept 1 helpful or not? Do you think that showing the foods in this way clearly communicates that these foods are meant to be limited? Why or why not? Which concept achieves this objective best? Why? [Probe for concept 1]: Can you please describe the image of the pizza? What does this represent for you? [MODERATOR: Trying to verify whether the pizza looks like it is from a frozen entrée rather than order out pizza] [Probe for concept 1 and 2 comparatives]: Concept 1 depicts ‘Use food labels’ with a label on a jar. Concept 2 depicts ‘Use food labels’ with a sample label. Which concept is clearer to understand?

b)	In looking at the icon and textual message together, what do you think the icon and message is intending to communicate as it relates to healthy eating?

c)

In looking at the food icons and the associated messages (eat a variety of healthy foods: plenty of vegetables and fruit, whole grain foods, and protein foods): Do any of the foods depicted surprise you? Which ones? why? Do you think the foods shown are simply examples of foods to represent the broader category of foods? OR Do you think they are meant to say you should be eating only these foods each day? Why or why not? Do you get the sense that the majority of the foods that are recommended for healthy eating are those that come from plants AND that healthy eating may also include foods that are not plants (like: white milk, meat (poultry, pork), fish, etc.)?

d)

Take a look at the placement of ‘vegetables & fruit’ in concept 1 (bottom centre) and concept 2 (top right) as well as the amount of vegetables and fruit depicted in both concepts. Does the placement or the amounts depicted in either concept signal to you a greater importance or do both placements and amounts depicted imply a similar level of importance of vegetables and fruits? Why do you say that?

WRAP-UP OF DIGITAL CONCEPTS:

• Respondent’s name:
• Respondent’s phone number: (home)
• Respondent’s phone number: (work)
• Respondent’s fax number:
• Respondent’s email:
• Sample source: panel random client referral
• Interviewer:
• Date:
• Validated:
• Quality Central:
• On list:
• On quotas:

Hello/Bonjour, my name is _______________ and I’m calling on behalf of the Earnscliffe Strategy Group, a national public opinion research firm. We are organizing a series of discussion groups on issues of importance to Canadians, on behalf of the Government of Canada, specifically for Health Canada. The purpose of the study and the small group discussion is to hear people’s opinions of healthy eating messages, images, icons and symbols. We are looking for people who would be willing to participate in a discussion group that will last up to two hours. These people must be 18 years of age or older. Up to 10 participants will be taking part and for their time, participants will receive an honorarium of $100.00. May I continue?

Yes	CONTINUE
No	THANK AND TERMINATE

Would you prefer that I continue in English or French? Préférez-vous continuer en français ou en anglais? [IF FRENCH, CONTINUE IN FRENCH OR ARRANGE A CALL BACK WITH FRENCH INTERVIEWER: Nous vous rappellerons pour mener cette entrevue de recherche en français. Merci. Au revoir].

Participation is voluntary. We are interested in hearing your opinions; no attempt will be made to sell you anything or change your point of view. The format is a ‘round table’ discussion led by a research professional. All information collected, used and/or disclosed will be used for research purposes only and the research is entirely confidential. But before we invite you to attend, we need to ask you a few questions to ensure that we get a good mix and variety of people. May I ask you a few questions; this should only take 5 minutes?

Yes	CONTINUE
No	THANK AND TERMINATE

S1.	Do you or any member of your household currently work for or have you or has any member of your household ever worked for…

IF “YES” TO ANY OF THE ABOVE, THANK AND TERMINATE.

S2.	DO NOT ASK – NOTE GENDER

	Male	1	ENSURE GOOD MIX OF GENDER
	Female	2

S3.	Could you please tell me which of the following age categories you fall in to? Are you…

18-24 years	1	ENSURE GOOD MIX OF AGE
25-29 years	2
30-34 years	3
35-44 years	4
45-54 years	5
55-64 years	6
65+ years	7
DK/NR	9	THANK AND TERMINATE

S4.	What is your current employment status?

Working full-time	1	ENSURE GOOD MIX OF EMPLOYMENT STATUS
Working part-time	2
Self-employed	3
Retired	4
Unemployed	5
Student	6
Stay at home parent	7
Other (please specify)	8
DK/NR	9	THANK AND TERMINATE

S5.	Which of the following categories best describes your total household income? That is, the total income of all persons in your household combined, before taxes [READ LIST]?

Under $20,000	1	ENSURE GOOD MIX OF INCOME
$20,000 to under $40,000	2
$40,000 to under $60,000	3
$60,000 to under $80,000	4
$80,000 to under $100,000	5
$100,000 to under $150,000	6
$150,000 or more	7
DK/NR	9	THANK AND TERMINATE

S6.	What is the last level of education that you have completed?

Elementary school	1
Some high school	2	ENSURE GOOD MIX OF EDUCATION
Completed high school	3
Some college/university	4
Completed college/university	5
Post-graduate studies	6
DK/NR	9	THANK AND TERMINATE

S7.	Which of the following best describes your current household situation? Are you living…?

By yourself	1	ENSURE GOOD MIX OF HOUSEHOLD SITUATION
As a single parent with your children at least some of the time	2
With a partner or spouse	3
With a partner or spouse and your children	4
As a blended family (with a spouse and yours and/or their children)	5
With your parents/caregiver only or with your parents/caregiver and sibling(s)	6
Other (please specify)	7
DK/NR	9	THANK AND TERMINATE

S8.	To make sure that we speak to a diversity of people, could you please tell me what is your ethnic background? DO NOT READ

Caucasian	1	ENSURE GOOD MIX OF ETHNICITY
Chinese	2
South Asian (i.e., East Indian, Pakistani, etc.)	3
Black	4
Filipino	5
Latin America	6
Southeast Asian (i.e. Vietnamese, etc.)	7
Arab	8
West Asian (i.e. Iranian, Afghan, etc.)	9
Korean	10
Japanese	11
Aboriginal (First Nations, Métis, or Inuit)	12
Other (please specify)	13
DK/NR	14

AIM FOR 1 ABORIGINAL IN TORONTO, QUEBEC CITY, AND CALGARY. AIM FOR 5 TO 6 IN WHITEHORSE. AIM FOR MIN 2 NON-CAUCASIAN IN EACH GROUP (WHEREVER POSSIBLE PARTICULARLY TORONTO AND CALGARY).

S9.	Which of the following best describes yourself?

		ENSURE GOOD MIX IN ALL GROUPS
I pay close attention to the food and beverages I consume, and I am very interested
in health related information	1	THANK AND TERMINATE
I pay some attention to the food and beverages I consume, and I am moderately interested
in health related information	2	THANK AND TERMINATE
I do not pay close attention to the food and beverages I consume, and I am not really interested
in health related information	3	THANK AND TERMINATE
DK/NR	4	THANK AND TERMINATE

S10.	Do you have a personal smartphone including an iPhone, Blackberry, Android, etc. that provides you with access to the Internet either via wifi or your own data?

Yes	1	CONTINUE
No	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S11.

As part of these discussion groups, participants will be required to bring their personal smartphones and asked to access the Internet to view information online and may be asked to download an app for the purposes of the discussion. Would you be willing to bring and use your smartphone during the discussion to review a website and an app in the groups?

Yes	1	CONTINUE
No	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

IF PARTICIPANT ASKS, CONFIRM THAT THE FOCUS GROUP FACILITY WILL HAVE WIFI ACCESS.

S12.	Have you participated in a discussion or focus group before? A discussion group brings together a few people in order to know their opinion about a given subject.

Yes	1	(MAX 1/3 PER GROUP, ASK S13, S14, S15)
No	2	SKIP TO S16
DK/NR	9	THANK AND TERMINATE

S13.	When was the last time you attended a discussion or focus group?

If within the last 6 months	1	THANK AND TERMINATE
If not within the last 6 months	2	CONTINUE
DK/NR	9	THANK AND TERMINATE

S14.	How many of these sessions have you attended in the last five years?

If 4 or less	1	CONTINUE
If 5 or more	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S15.	And what was/were the main topic(s) of discussion in those groups?

IF RELATED TO FOOD, HEALTHY EATING, NUTRITION/DIET, CANADA’S FOOD GUIDE, THANK AND TERMINATE.

S16.	We are asking participants about nutrition information that appears on all pre-packaged foods. To do that, I need to email you a sample nutrition label and ask you some questions about it. I would like to do that now so we can continue with the questions. Do you have immediate access to your email?

Yes	1	SEE INTERVIEWER INSTRUCTIONS
No	2	SEE INTERVIEWER INSTRUCTIONS

INTERVIEWER INSTRUCTIONS:

IF YES:

Email nutrition label email and confirm they can view the label before proceeding with asking the remaining questions on the screener.

IF NO:

Set up a time for a call-back when they are able to have the email in front of them during the recruitment call and continue with the screening questions.

ICE CREAM CONTAINER LABEL TO BE EMAILED

S17.	The first question based on the information from the label is: if you eat the entire container, how many calories will you eat?

S18.	If you are allowed to eat 60 grams of carbohydrates as a snack, how much ice cream can you have?

S19.	Your doctor advises you to reduce the amount of saturated fat in your diet. You usually have 42 g of saturated fat each day, which includes one serving of this particular ice cream. If you stop eating ice cream, how many grams of saturated fat would you be eating each day?

S20.	If you usually eat 2,500 calories in a day, what percentage of your daily value of calories will you be eating if you eat one serving of this ice cream?

S21.	Pretend that you are allergic to the following substances: penicillin, peanuts, latex gloves and bee stings. Is it safe for you to eat this ice cream?

S22.	[ASK ONLY IF ANSWER TO Q.S21 IS “NO”] Why not?

SCORING SHEET

Answer	Correct	Not Correct	Correct response should be
Q.S17			1,000
Q.S18			(a)  250 ml or 1 cup (or any amount up to 250 ml or 1 cup), OR (b)  half the container
Q.S19			33
Q.S20			10
Q.S21			No
Q.S22			Because it has peanuts/peanut oil
TOTAL SCORE

INVITATION

S23.	Participants in discussion groups are asked to voice their opinions and thoughts. How comfortable are you in voicing your opinions in front of others? Are you… (READ LIST)

Very comfortable	1	MINIMUM 4 PER GROUP
Fairly comfortable	2	CONTINUE
Comfortable	3	CONTINUE
Not very comfortable	4	THANK AND TERMINATE
Very comfortable	5	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S24.	Sometimes participants are asked to read text and/or review images during the discussion. Is there any reason why you could not participate?

Yes	1	THANK AND TERMINATE
No	2	CONTINUE
DK/NR	9	THANK AND TERMINATE

S25.

Based on your responses, it looks like you have the profile we are looking for. I would like to invite you to participate in a small group discussion, called a focus group, we are conducting at [TIME], on [DATE]. As you may know, focus groups are used to gather information on a particular subject matter; in this case, the discussion will touch on the food choices you make. The discussion will consist of 8 to 10 people and will be very informal. It will last up to two hours, refreshments will be served and you will receive $100.00 as a thank you for your time. Would you be willing to attend?

Yes	1	RECRUIT
No	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

PRIVACY QUESTIONS
Now I have a few questions that relate to privacy, your personal information and the research process. We will need your consent on a few issues that enable us to conduct our research. As I run through these questions, please feel free to ask me any questions you would like clarified.

P1)

First, we will be providing the hosting facility and session moderator with a list of respondents’ names and profiles (screener responses) so that they can sign you into the group. This information will not be shared with the Government of Canada department organizing this research. Do we have your permission to do this? I assure you it will be kept strictly confidential.

Yes	1	GO TO P2
No	2	READ RESPONDENT INFO BELOW

We need to provide the facility hosting the session and the moderator with the names and background of the people attending the focus group because only the individuals invited are allowed in the session and the facility and moderator must have this information for verification purposes. Please be assured that this information will be kept strictly confidential. GO TO P1A

P1a)	Now that I’ve explained this, do I have your permission to provide your name and profile to the facility?

Yes	1	GO TO P2
No	2	THANK & TERMINATE

P2)

An audio and/or video tape of the group session will be produced for research purposes. The tapes will be used only by the research professional to assist in preparing a report on the research findings and will be destroyed once the report is completed. Do you agree to be audio and/or video taped for research purposes only?

Yes	1	THANK & GO TO P3
No	2	READ RESPONDENT INFO BELOW

It is necessary for the research process for us to audio/video tape the session as the researcher needs this material to complete the report.

P2a)	Now that I’ve explained this, do I have your permission for audio/video taping?

Yes	1	THANK & GO TO P3
No	2	THANK AND TERMINATE

P3)

Each month we submit the names of individuals that have participated in our focus groups to the Marketing Research and Intelligence Association Qualitative Central system (www.mria-arim.ca). Qualitative Central serves as a centralized database to review participation in qualitative research and focus groups. You will not be contacted for any reason whatsoever as a result of being on this list. Do we have your permission to submit your name and phone number to MRIA’s Qualitative Central system?

Yes	1	THANK & GO TO INVITATION
No	2	GO TO P3A

P3a)

To participate in this focus group we must have your permission to add your name to the Qualitative Central system as it is the only way for us to ensure the integrity of the research process and track participation in qualitative research. The system is maintained by the industry body, the Professional Marketing Research Society, and is solely used to track your participation in qualitative research (such as focus groups). You will not be contacted for any reason whatsoever as a result of being on this list. Now that I've explained this do I have your permission to add your name to our qualitative central list?

Yes	1	THANK & GO TO INVITATION
No	2	THANK & TERMINATE

• Respondent’s name:
• Respondent’s phone number: (home)
• Respondent’s phone number: (work)
• Respondent’s fax number:
• Respondent’s email:
• Sample source: panel random client referral
• Interviewer:
• Date:
• Validated:
• Quality Central:
• On list:
• On quotas:

Hello/Bonjour, my name is (insert name) and I’m calling on behalf of the Earnscliffe Strategy Group, a national public opinion research firm. We are organizing a series of discussion groups on issues of importance to Canadians, on behalf of the Government of Canada, specifically for Health Canada. The purpose of the study and the small group discussion is to hear people’s opinions of healthy eating messages, images, icons and symbols. We are looking for people who would be willing to participate in a discussion group that will last one hour. These people must be 18 years of age or older. Up to 7 participants will be taking part and for their time, participants will receive an honorarium of $175.00. May I continue?

Yes	CONTINUE
No	THANK AND TERMINATE

Would you prefer that I continue in English or French? Préférez-vous continuer en français ou en anglais? [IF FRENCH, CONTINUE IN FRENCH OR ARRANGE A CALL BACK WITH FRENCH INTERVIEWER: Nous vous rappellerons pour mener cette entrevue de recherche en français. Merci. Au revoir].

Participation is voluntary. We are interested in hearing your opinions; no attempt will be made to sell you anything or change your point of view. The format is a ‘round table’ discussion led by a research professional. All information collected, used and/or disclosed will be used for research purposes only and the research is entirely confidential. But before we invite you to attend, we need to ask you a few questions to ensure that we get a good mix and variety of people. May I ask you a few questions; this should only take 5 minutes?

Yes	CONTINUE
No	THANK AND TERMINATE

S1.	Do you or any member of your household currently work for or have you or has any member of your household ever worked for…

IF “YES” TO ANY OF THE ABOVE, THANK AND TERMINATE.

S2.	DO NOT ASK – NOTE GENDER (ATTEMPT TO ENSURE A GOOD MIX)

	Male	1
	Female	2

S3.	What is your current employment status?

Working full-time	1	CONTINUE
Working part-time	2	CONTINUE
Self-employed	3	CONTINUE
Retired	4	THANK AND TERMINATE
Unemployed	5	THANK AND TERMINATE
Student	6	THANK AND TERMINATE
Stay at home parent	7	THANK AND TERMINATE
Other (PLEASE SPECIFY, CONTINUE IF “VOLUNTEER”)	8
DK/NR	9	THANK AND TERMINATE

IF SAYS “OTHER” AND “OTHER” INCLUDES “VOLUNTEER”, CONTINUE; OTHERWISE THANK AND TERMINATE.

S4.	Are you a…?

Elementary school teacher (JK, SK, up to Grade 6)	1	CONTINUE FOR MINI-GROUP 1
Community level educator working/volunteering at a YMCA, recreation centre, community centre, community kitchen, library, Girl Guides, Scouts, senior centre, family resource centre,
or something similar (SPECIFY)	2	CONTINUE FOR MINI-GROUP 2
Registered dietitian	3	CONTINUE FOR MINI-GROUPS 3/4
Registered nurse working in community or public health (so NOT in clinical/hospital
or long-term care, etc.)	4	CONTINUE FOR MINI-GROUP 5

MUST SAY “YES” TO AT LEAST ONE, OTHERWISE THANK AND TERMINATE.

S5.	(IF REGISTERED DIETITIAN AT QS4) Which of the following best describes your role?

I am a public health dietitian, working in areas such as policy development, development of healthy eating guidelines, campaigns or for a health authority, public health unit,
or school board	1	CONTINUE FOR MINI GROUP 3
I am a community dietitian, working with the general public in a community setting such as a
health authority or community centre	2	CONTINUE FOR MINI GROUP 3
I am a clinical dietitian, working in a community health clinic, hospital, nursing
home or other health care facility	3	RECRUIT FOR MINI GROUP 4
I am a dietitian working in private practice, working with individuals and/or small groups either in person
or through media/blogs	4	RECRUIT FOR MINI GROUP 4
I am an administrative dietitian that works in foodservice Facility that provides food to large organizations (i.e., school/university
Cafeteria, hospital or other business)	5	THANK AND TERMINATE

S6.	Does part of your role include educating on and/or communicating healthy eating information (including the food guide)?

Yes	1	CONTINUE
No	2	THANK AND TERMINATE

S7.	Do you have a tablet and/or laptop that you use for work?

Yes	1	CONTINUE
No	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S8.

As part of these discussion groups, participants will be required to bring their tablets and/or laptops and asked to access the Internet to view information online and may be asked to download an app for the purposes of the discussion. Would you be willing to bring and use your tablet and/or laptop during the discussion to review a website and an app in the groups?

Yes	1	CONTINUE
No	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

IF PARTICIPANT ASKS, CONFIRM THAT THE FOCUS GROUP FACILITY WILL HAVE WIFI ACCESS.

S9.	Have you participated in a discussion or focus group before? A discussion group brings together a few people in order to know their opinion about a given subject.

Yes	1	(MAX 1/3 PER GROUP, ASK S10, S11, S12)
No	2	SKIP TO S13
DK/NR	9	THANK AND TERMINATE

S10.	When was the last time you attended a discussion or focus group?

If within the last 6 months	1	THANK AND TERMINATE
If not within the last 6 months	2	CONTINUE
DK/NR	9	THANK AND TERMINATE

S11.	How many of these sessions have you attended in the last five years?

If 4 or less	1	CONTINUE
If 5 or more	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S12.	And what was/were the main topic(s) of discussion in those groups?

IF RELATED TO FOOD, HEALTHY EATING, NUTRITION/DIET, CANADA’S FOOD GUIDE, THANK AND TERMINATE.

INVITATION

S13.	Participants in discussion groups are asked to voice their opinions and thoughts. How comfortable are you in voicing your opinions in front of others? Are you… (READ LIST)

Very comfortable	1	MINIMUM 4 PER GROUP
Fairly comfortable	2	CONTINUE
Comfortable	3	CONTINUE
Not very comfortable	4	THANK AND TERMINATE
Very comfortable	5	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

S14.	Sometimes participants are asked to read text and/or review images during the discussion. Is there any reason why you could not participate?

Yes	1	THANK AND TERMINATE
No	2	CONTINUE
DK/NR	9	THANK AND TERMINATE

S25.

Based on your responses, it looks like you have the profile we are looking for. I would like to invite you to participate in a small group discussion, called a focus group, we are conducting at [TIME], on [DATE]. As you may know, focus groups are used to gather information on a particular subject matter; in this case, the discussion will touch on the food choices you make. The discussion will consist of approximately 7 people and will be very informal. It will last approximately one hour, refreshments will be served and you will receive $175.00 as a thank you for your time. Would you be willing to attend?

Yes	1	RECRUIT
No	2	THANK AND TERMINATE
DK/NR	9	THANK AND TERMINATE

Please remember that all information discussed in this group will be confidential and should not be shared outside the room in which the discussion will be held. If you take notes, you will have to leave them at the end of the session. We also ask in advance that you refrain from using your cell phone during the session.

PRIVACY QUESTIONS
Now I have a few questions that relate to privacy, your personal information and the research process. We will need your consent on a few issues that enable us to conduct our research. As I run through these questions, please feel free to ask me any questions you would like clarified.

P1)

First, we will be providing the hosting facility and session moderator with a list of respondents’ names and profiles (screener responses) so that they can sign you into the group. This information will not be shared with the Government of Canada department organizing this research. Do we have your permission to do this? I assure you it will be kept strictly confidential.

Yes	1	GO TO P2
No	2	READ RESPONDENT INFO BELOW

We need to provide the facility hosting the session and the moderator with the names and profiles of the people attending the focus group because only the individuals invited are allowed in the session and the facility and moderator must have this information for verification purposes. Please be assured that this information will be kept strictly confidential. GO TO P1A

P1a)	Now that I’ve explained this, do I have your permission to provide your name and profile to the facility?

Yes	1	GO TO P2
No	2	THANK & TERMINATE

P2)

An audio and/or video tape of the group session will be produced for research purposes. The tapes will be used only by the research professional to assist in preparing a report on the research findings and will be destroyed once the report is completed. Do you agree to be audio and/or video taped for research purposes only?

Yes	1	THANK & GO TO P3
No	2	READ RESPONDENT INFO BELOW

It is necessary for the research process for us to audio/video tape the session as the researcher needs this material to complete the report.

P2a)	Now that I’ve explained this, do I have your permission for audio/video taping?

Yes	1	THANK & GO TO P3
No	2	THANK AND TERMINATE

P3)

Each month we submit the names of individuals that have participated in our focus groups to the Marketing Research and Intelligence Association Qualitative Central system (www.mria-arim.ca). Qualitative Central serves as a centralized database to review participation in qualitative research and focus groups. You will not be contacted for any reason whatsoever as a result of being on this list. Do we have your permission to submit your name and phone number to MRIA’s Qualitative Central system?

Yes	1	THANK & GO TO INVITATION
No	2	GO TO P3A

P3a)

To participate in this focus group we must have your permission to add your name to the Qualitative Central system as it is the only way for us to ensure the integrity of the research process and track participation in qualitative research. The system is maintained by the industry body, the Professional Marketing Research Society, and is solely used to track your participation in qualitative research (such as focus groups). You will not be contacted for any reason whatsoever as a result of being on this list. Now that I've explained this do I have your permission to add your name to our qualitative central list?

Yes	1	THANK & GO TO INVITATION
No	2	THANK & TERMINATE