Social Desirability and Social Approval Biases in Dietary Self-Report: Examples of Epidemiologic Effect Modification

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Social Desirability and Social Approval Biases in Dietary Self-Report: Examples of Epidemiologic Effect Modification James R. Hebert, ScD Professor and Chair Department of Epidemiology and Biostatistics Norman J. Arnold School of Public Health University of South Carolina

Other Collaborators: Lynn Clemow, Ph.D. Ira S. Ockene, M.D. Cara B. Ebbeling, Ph.D. Yunsheng Ma, M.D., M.P.H. Thomas G. Hurley, M.Sc. Milagros C. Rosal, Ph.D. Charles E. Matthews, Ph.D. Judith K. Ockene, Ph.D.

You must child! psychological troubles passionate viewpoints issues of prying deluding reactions

Emotional Aspects of Eating - same piece of mind procedures impressions of taste, smell, and fundamental enthusiastic and instinctual conduct. social messages get overlaid on mental and enthusiastic ones.

Background Self-report of dietary admission could be one-sided by social allure or social endorsement accordingly influencing hazard gauges in epidemiologic studies. These develops deliver reaction set predispositions, which are apparent when testing in areas described by effortlessly conspicuous right or alluring reactions. Given the social and mental esteem credited to eating regimen, evaluation approachs utilized most ordinarily as a part of epidemiologic studies are especially helpless against these inclinations.

Social Desirability is a Response Set mirroring the protective propensity to react so as to keep away from feedback in a circumstance saw to be a test.

Social Approval is a Response Set mirroring the propensity to effectively look for endorsement in a circumstance saw to be a test.

Social attractive quality predisposition in dietary self-report may bargain the legitimacy of dietary admission measures. Universal Journal of Epidemiology 1995; 24: 389-398.

WATCH W ORCESTER A REA T RIAL for C OUNSELING in H YPERLIPIDEMIA

We Developed Seven-Day Diet Recall (7DDR) In WATCH The 7DDR looks especially like a FFQ, yet it requests that members review particular dinners and snacks over the previous week. It incorporates 118 sustenances, 13 refreshments, and a worksheet. Accordingly it joins components of the FFQ and produces assessments of dietary admission more like attribute measures than does 24HR.

STUDY DESIGN WATCH External Validation Study 3 Weeks Pre 7DDR Post 7DDR (7 arbitrarily chose 24-Hrs) Exactly two years after the fact social attractive quality and endorsement evaluated

Hypothesis: Response Set Biases are communicated on organized surveys, for example, the Seven Day Dietary Recall (7DDR) or the FFQ. ¨ it is shut finished and has evident right responses network like clear reaction classes requires report of eating regimen as a quality as opposed to a state ¨

Methods : Social allure and social endorsement predispositions were tried by looking at supplement scores got from various twenty-four hour consume less calories reviews (24HR) on arbitrarily relegated days with those from two seven-day eat less carbs reviews (7DDR) (comparative in a few regards to generally utilized nourishment recurrence surveys), one regulated toward the start of the trial (pre) and one toward the end (post). Factual investigation included relationship and numerous straight relapse. With the exception of b portraying connection between strategies (where b ought to approach 1.0) , H 0 : b =0.

Social Desirability Approval Assessment Marlowe-Crowne Social Desirability Scale Martin-Larsen Approval Motivation Scale 33-thing (genuine/false) 20-thing (5-point Likert)

Summary Statistics (from 24HR) Women (n=27) Men (n=14) Energy (kcal/d) 1491 (62) 1971 (600) Fat (g/d) 51.9 (17.3) 65.1 (23.8) % Fat 31.3 (5.5) 29.4 (4.6) Calcium (mg/d) 668 (277) 785 (218) Cholesterol (mg/d) 185 (65) 261 (195) * Tabulated qualities are mean (standard deviation)

WATCH – External Validation Study – Summary Statistics Variable % or Mean/SD Female Male (N=27) (N=14) % Married 74.1% 64.3% % White 81.5% 85.7% Age (years) 51.3/16.1 47.2/13.9 Social Desirability Score 20.5/6.4 18.5/5.9 Social Approval Score 48.4/9.6 44.9/9.1 Total vitality (k/cal) 1490/461 1970/599 Total fat (g) 51.9/17.3 65.1/23.8

Statistical Model Nutrient test strategy = Nutrient examination technique + Social Approval + Social Desirability + BMI + Covariates

WATCH – External Validation Study – Regression Results (Pre) 24-HR Score SD Score Total Energy (kcal) b = 0.96 - 50.23 SE b = 0.27 22.58 P-esteem = n.s. (0.06) Total fat (g) 1.41 - 2.34 0.39 1.17 n.s. (0.06) Saturated unsaturated fats (g) 1.35 - 0.68 0.29 0.32 n.s. (0.04)

WATCH – External Validation Study – Regression Results (Post) 24-HR Score SD Score Total Energy (kcal) b = 0.97 - 25.50 SE b = 0.17 14.49 P-esteem = n.s. (0.09) Total fat (g) 0.90 - 1.18 0.20 0.59 n.s. (0.06) Saturated unsaturated fats (g) 0.87 - 0.30 0.17 0.20 n.s. n.s.

Results of General Linear Models to Assess Gender Differences In Social Desirability Bias Pre Measurements Post Measurements Women Men Women Men b SE b SE b b SE b SE b Dependent Variable Total fat(g) -3.36 (1.57) - 1.11 (1.79) - 2.06 (0.64) - 0.35 (1.43) Saturated greasy acids -0.85 (0.45) -0.29 (0.67) - 0.62 (0.21) 0.22 (0.49) Total vitality (kcal) - 68.05 (30.31) - 38.90 (32.00) - 47.33 (14.35) -17.31 (32.97) Fat (% vitality) - 0.33 (0.23) - 0.13 (0.20) -0.01 (0.22) - 0.09 (0.21) Cholesterol -7.17 (2.55) - 11.25 (7.56) -3.68 (2.13) 1.48 (6.00)

Results of supplement quartile stratification to evaluate variety in social attractive quality predisposition Pre Measures Post Measures Dependent Variable b Se b SE b Fat Quartile 1 -1.11 0.85 - 1.15 0.64 Quartile 2 0.33 0.65 - 0.29 0.32 Quartile 3 -1.42 1.12 - 1.48 0.24 Quartile 4 -3.62 2.95 - 1.65 1.08 Total Energy Quartile 1 -18.88 19.56 - 22.17 5.76 Quartile 2 6.39 3.42 10.27 4.90 Quartile 3 -22.79 11.22 13.34 24.01 Quartile 4 -72.66 84.96 - 13.02 45.27

WATCH – External Validation Study Conclusions: A descending inclination in the 7DDR because of social desirability was seen in ladies. It added up to around 700 kcal/day over the interquartile scope of social attractive quality scores for ladies Slide 20

WATCH Study Hebert JR, Ma Y, Clemow L, Ockene IS, Saperia G, Stanek EJ, Merriam PA, Ockene JK. Sex contrasts in social attractive quality and social endorsement predisposition in dietary self report. Am J Epidemiol 1997; 146:1046-1055. The general motivation behind the Worcester Area Trial for Counseling in Hyperlipidemia was: To assess the adequacy of a doctor conveyed sustenance intercession advising program in decreasing dietary fat and LDL

Data Collection in WATCH Study: Over 8,000 patients screened to decide qualification Age 20-65 years No earlier medication treatment and RD referral First fingerstick for testing cholesterol Upper 25% of cholesterol circulation Second fingerstick Consent 1,278 patients One year Single 24HR 7DDR 2 lipid profile BMI(kg/m 2 ) SD and SA measures March 1995 Baseline Single 24HR 7DDR 2 lipid profiles BMI(kg/m 2 )

Responders Vs. Non-Responders Variable Responders Non-responder P-esteem * MEAN (SD) MEAN (SD) Age (Years) 49.44 (10.63) 48.29 (10.45) 0.06 Baseline BMI 28.80 (5.29) 29.51 (5.90) 0.05 Baseline Blood Cholesterol (mg/dl) 233.60 (46.85) 223.48 (56.59) 0.0008 Baseline LDL Cholesterol (mg/dl) 152.82 (39.39) 148.89 (43.19) 0.01 # of additional lipid measures from Fallon 2.15 (1.26) 1.92 (1.22) 0.01 *P esteem in view of Chi-square for straight out factors and two specimen t-test the two gathering implies

Male and Female Comparison Male (n=325) Female (n=434) MEAN SD# MEAN SD# P-value* 7DDR Nutrients at Baseline Total Energy (kcal/d) 2085.63 927.83 1786.32 752.11 0.0001 Total Fat (g/d) 88.22 50.94 77.49 41.76 0.004 % Calories from Fat 37.11 8.96 38.17 8.73 0.12 Saturated Fat (g/d) 29.39 17.66 25.25 13.50 0.0009 % Calories from Saturated Fat 12.38 3.78 12.55 3.44 0.52 *P esteem in light of two example t-test the distinction of two gathering implies

Results of GLM for Males, WATCH Study Independent Variables: Dependent Variables: 24HR SD SCORE AP SCORE BMI Total Fat (g/d) b 0.29 0.70 1.21 1.04 (p) (0.0003) (0.24) (0.01) (0.04) Total Saturated Fat (g/d) b 0.26 0.25 0.45 0.50 (p) (0.0001) (0.23) (0.001) (0.05) Total Energy (kcal/d) b 0.36 9.18 21.50 27.24 (p) (0.0001) (0.38) (0.01) (0.01)

Results of GLM for Females, WATCH Study Independent Variables: Dependent Variables: