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«Saoussen LAKHDAR Assistante contractuelle, ISCAE Tunis, Tunisie Doctorante en marketing, Faculté des Sciences Economiques et de Gestion, Tunis, ...»

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Similarly, Zeithaml (1988) state that price appears as a relevant quality cue when consumer do not have adequate information about intrinsic quality cues, or when it is the only available cue. As a consequence, this extrinsic cue can represent by analogy to food quality perception an antecedent to the food healthiness perception which is a dimension of quality perception (Grunert, 2007). Confirming this statement, Ottman (1992) attest that since the consumers feel that the food offers perceived health, they are willing to pay premium price (Ottman, 1992).

Healthiness as perceived attribute through personal characteristics Personals influences on the perception of food healthiness can be divided into demographic characteristics such as age, gender, income, education, BMI (Body Mass Index), diet status, etc. (e.g. Worsley and Skrzypiec, 1998; Oakes and Slotterback, 2002; Urala and Lähteenmäki, 2004; Verbeke, 2005; Carels, Konrad and Harper, 2007) and personality traits such as, health concern, food neophobia, exploratory behavior, self efficacy, locus of control, health belief, etc. (e.g. Abusabha and Achterberg, 1997; Van Trijp and Steenkamp, 1992; Worsley and Skrzypiec, 1998; Rozin, 2007).

Although demographic characteristics have usually a clear predictive value in consumer behavior, they have not proven to be major predictors of food choice with very few exceptions such as the large gender difference in concern about weight, which manifests in dieting and food choice, in the developed world (Rozin et al., 2003; Rozin, 2007). Few researches have attempted to counter this evidence, especially in the judgment of food healthfulness.

Rappoport, Peters, Downey, McCann and Huff-Corzine (1993) showed that women have more knowledge about the health value of foods and a border understanding of food healthfulness than men. The same authors reported that men have a “much simpler cognitive structure” than women when judging the healthiness of food. Similarly, the studies of Slotterback and Oakes (2000) and Oakes and Slotterback (2001a, 2001b, 2002) found recently the same results. According to these authors, women report being more health conscious, reading nutrition labels more often and eating healthier foods than men. Moreover, these studies showed that when evaluating food healthiness, women appear to depend on fat content more than other characteristics, while men look for information on vitamin, mineral and protein content on food labels.

According to the literature review of Oakes and Slotterback (2001b) on the influence of age on nutritional label use (Neuhouser, Kristal & Patterson, 1999), healthy eating habits (Hunt et al., 1997; Reime et al., 2000), dietary fat intake (Stafleu et al., 1994), motives underlying food selection (Steptoe, Pollard and Wardle, 1995), dieting status (Slotterback and Oakes, 2000) and importance of personal appearance (Tiggemann, 1992), there are many reasons to believe that age influences also the evaluation of food healthfulness. These studies showed clearly that there is a general belief on the fact that older people are more concerned about healthy eating as health issues related to disease represent a great concern for them in order to extend their lives. On the other hand, young people are less concerned about food healthfulness as they emphasize health only in terms of personal appearance through weight and body shape.

While the majority of studies on food choice have shown that cost is the major barrier to healthy eating, there are few plausible explanations that may confirm the link between income and evaluation of food healthiness. Perhaps the major explanation can be the large difference of priorities on food choice between low-income and high income individuals. According to Bourdieu (1995), working class- individuals prefer “the heavy, the fat and the coarse” because they emphasis on the importance of the strength of the male body. Hence, they chose cheap and nutritious food to build and fuel such a physique. However, high-status individuals like professionals and senior executives tend towards ‘the light, the refined and the delicate’, as they maintain a ‘new ethic of sobriety and slimness’ which serves to set them apart from popular.

In addition to demographic characteristics, social and cognitive psychological studies have determined several cognitive predictors of health and diet-related behaviors. Abusabha and Achterberg (1997) clarified the distinctions among cognitive variables such as health value, self-efficacy, locus of control, health belief and illustrated them within the context of nutrition and health.

Health concern appears as one of the most important predictor of food perceived healthiness.

It represents basically the importance of health to an individual but it reflects also individual’s concern with health issues and the determination to maintain or improve health (Tudoran, Ottar Olsen, and Dopico, 2009). It includes consideration about immediate consequences on physical well-being such as allergic reactions, post-ingestional effects of the food and longerterm consequences on health such as chronic diseases prevention and weight control (Sobal, Bisogni, Devine, and Jastran, 2006). Several studies have examined the influence of health concern on the food choice (e.g. Lau, Hartman, and Ware, 1986; Falk, Bisogni, and Sobal 1996; Furst, Connors, Bisogni, Sobal, and Falk, 1996; Smartand Bisogni, 2001; Sparks, Conner, James, Shepherd, and Povey, 2001; Olsen, 2006; Sobal et al., 2006; Sun, 2008).

These studies use different conceptualizations when talking about the importance of health to individuals. While some authors use the terms of “health involvement” (Maddock, Leek, and Foxall, 1999; Olsen, 2003), or “health-conscious self-identity” (Sparks et al., 2001; Olsen, 2006), others authors use the terms of “health concern” (Bower, Saadat and Whitten, 2003;

Sun, 2008), “Health interest” (Roininen, Lähteenmäki, and Tuarila, 1999), or “health value” (Abusabha and Achterberg, 1997; Sobal et al., 2006; Tudoran et al., 2009). Leaving aside the conceptualizations used, there is a general belief that health concern influences positively attitudes toward healthy eating, functional foods in particular (Olsen, 2003; Sun, 2008; Ares, Giménez, and Gámbaro, 2009; Tudoran et al., 2009; Verbeke, Scholderer, and Lähteenmäki, 2009).

Moreover, self-efficacy which was introduced by Bandura (1977) in his famous social cognitive theory refers to the individual conviction of being able to master specific activities, situations or aspects of his or her own psychological and social functioning. In other words, it reflects a person’s belief in his or her ability to overcome the difficulties inherent in performing a specific task in a particular situation (Abusabha and Achterberg, 1997). Smith et al., (1992) showed that more self-efficacy beliefs and expectations were associated with lower dietary fat and higher dietary fiber density. Besides, Sheeshka et al., (1993) reported that selfefficacy was the most important predictor of intentions to adopt healthful eating choices.

Sanders-Phillips (1994) reported that lower self-efficacy scores were associated with lowers levels of intent to change eating habits.

Health belief is another major construct that may influence perceived healthiness. According to the theory of reasoned action (Fishbein and Ajzen, 1975) and the theory of planed behavior (Ajzen, 1985), beliefs based on simple observation, scientific evidence or supposition about a food’s attribute shape one’s attitude toward that attribute. In fact according to Health Belief

Model (Rosenstock, 1974), health attribute can be perceived through four health beliefs:

perceived susceptibility to a considered illness, perceived severity of a considered illness, perceived benefits like preventing illness or improving health and perceived barriers.


The major aim of this study is to identify which cues Tunisian consumers use to evaluate the healthiness of food in general and functional food in particular and to understand how perceived healthiness can be a predictor of food purchase. In fact, we judged that qualitative methods, projective techniques in particular are suitable tools to meet this target.

According to Given (2008), “Qualitative research is designed to explore the human elements of a given topic, where specific methods are used to examine how individuals see and experience the world”. Research studies that are qualitative are designed to discover what can be learned about the how and the why of human perception about a specific concept.

Several studies have used qualitative methods to produce emergent conceptualizations of how people think about and engage in food choices. According to Levy (2006), Jean brillatSavarin was the first researcher who used what we called in the recent decades qualitative techniques to unravel the complexity of food and eating. The most famous finding of his work “The physiology of taste”, published in 1825 is “Tell me what you eat and will tell what you are”. Later, Rogers (1967) uses projective techniques in interviewing farmers. More recently, the use of qualitative methods have increased spectacularly in food choice studies (e.g. Furst et al., 1996; Nielsen, Soren and Grunert, 1997; Nielsen, bech-Larsen and Grunert, 1998;

Bredhal, 1999; Bech Larsen, 2001; Grunert et al., 2001; Bisogni et al., 2002; Roininen, Arvola and Lähteenmäki, 2006 ; Sijtsema et al., 2007).

There are several techniques which can be discussed under “qualitative methods” umbrella such as personal interviewing, focus group interviewing, projective techniques, ethnography, case studies, photography, laddering and story-telling (Levy, 2006).

Projective techniques were selected for this study as they are the most suitable qualitative method to answer our research’s questions. These techniques were borrowed by behavioral science literature from psychoanalysis clinical psychology between 1940 and 1960. After World War II, their use rises spectacularly in advertising agencies and market research firms (Rook, 2006). The most known study of this period was published in Journal of Marketing by Haire (1950). In his article, Haire subtly defines projective techniques as: “a test that involves presenting the subject with an ambiguous stimulus, one that does not quite make sense in itself, and asking him to make sense of it. The theory is that in order to make it make sense he will have to add it, to fill out the picture, and in so doing he projects part of himself into it.

Since we know what was in the original stimulus, we can quite easily identify the parts that were added, and, in this way, painlessly obtain information about the person”. In this definition, it’s clearly explained that the major aim of projective methods is to access thoughts or feeling that are not easily accessible to research participants (Gorden and Langmaid, 1988).

Similarly, Dichter (1960) defines projective techniques as a non-directive interview technique where the respondent can object himself onto another by revealing repressed or withheld thoughts, feeling and fears. The concomitant use of projective techniques can be explained by the fact that it exhibit more research design and task variety than any other qualitative method (Rook, 2006). These techniques have been categorized in five groups in terms of response types required of subjects (Gorden and Langmaid, 1988): association (word, picture, personification, etc.), construction (thematic story-telling, picture, collage, etc.), completion (sentence, story, conversation, bubbles, etc.), expressive (role-play, draw, etc.) and choice ordering.

This study consists of two parts: Four focus groups and ten in-depth interviews. The both qualitative methods often work well in combination. We preferred use focus groups as a first step, followed by further data collection with in-depth interview. The outcomes of focus groups are explored and lighted during the in-depth interviews. Besides, we used some finding of focus groups as input in techniques involved in in-depth interviews. The technique of story completion involved in in-depth interview for example was widely inspired of focus groups’ outcomes.

Focus groups Four focus groups were conducted in Tunis with a total of 24 participants. Participants were selected with different age, gender and socio-economic characteristics. There were 14 women and 10 men (58% vs. 42%). Ages ranged from 18 to 64 (mean age = 41). In order to promote homogeneity in each group, participants were chosen with similar demographic characteristics as it is recommended by several studies (e.g. Morgan, 1988, 1997; Krueger et al., 2000; Stewart et al., 2007). Homogeneous groups allow respondents to realize that they all come from a similar area and background and create more dynamic environment that enables spontaneous issues to arise from the discussion and participants to share feelings and experience that are of importance to themselves. In fact, focus groups were differentiated by age and socio-economic situation. We formed one group of younger males and females (18with low or middle socio-economic situation, one group of younger males and females with higher socio-economic situation and two groups of older males and females (30-64) with different socio-economic situation in each group.

The focus groups sessions last approximately two hours. Each session started with a general introduction to avoid any expectation that the group will be formal and acting as a test of the participants’ competence (Puchta and Potter, 2004). The introduction which consists of presenting the moderator, the study, the method and the participants helps to generate a situation that is relaxed and informal. After the introduction, the discussion started with open questions concerning the relation to food, food choice and healthy food choice in particular.

They were designed to be easy to answer in order to encourage everyone to participate in the discussion and to alleviate difficulties associated with speaking in front of a group of strangers and help to build up a good rapport between participants (Wilkinson, 1998).

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