NIJZ and WHO Capacity building workshop 2017 DIGITAL MARKETING TO CHILDREN Methodological challenges for linking public health silos Book of Abstracts Organized by: National Institute of Public Health Slovenia and WHO Country Office in Slovenia Ljubljana, 12th October 2017 Publication title: DIGITAL MARKETING TO CHILDREN - Methodological challenges for linking public health silos Book of Abstracts Editors: Mojca Gabrijelčič Blenkuš, Mateja Juvan and Petra Klepac Reviewers: Tit Albreht, Helena Jeriček Klanšček Publisher: National Institute of Public Health Trubarjeva 2, 1000 Ljubljana, Slovenia E-mail: info@nijz.si Telephone: +386 1 2441 400 Website: www.nijz.si Place and date of publication: Ljubljana, 2018 First published 2018 E-publication: http://www.nijz.si/sl/publikacije Text is not proofread. Copyright © National Institute of Public Health, Slovenia All rights reserved. Reproduction in part or whole in any way and by any media without the written consent of the author is prohibited. Violations are sanctioned in accordance with copyright and criminal law. ___________________________________________________________________________ CIP - Cataloguing in Publication National and University Library, Ljubljana, Slovenia COBISS.SI-ID=293634816 ISBN 978-961-7002-50-8 (pdf) Table of Contents Review ........................................................................................................................................ 1 1 Introduction ........................................................................................................................ 3 2 Programme ......................................................................................................................... 4 3 Digital marketing – a new determinant of a healthy lifestyle and NCDs in children ......... 6 4 Digital marketing as a lifestyle determinant – technical, ethical and nutritional challenges ................................................................................................................................. 18 5 Digital “natives” – how do they perceive digital marketing? ........................................... 42 6 Digital marketing – how it works? .................................................................................... 51 7 Comparative analyses of (digital) marketing in different lifestyle areas .......................... 59 8 Opportunities and barriers for policy interventions ......................................................... 74 9 Short statement on technological options in Slovenia ..................................................... 85 10 Conclusions and recommendations .............................................................................. 92 11 References ..................................................................................................................... 95 Review Digital marketing is an important challenge for public health. On the one hand, the pressure of the different industries steering and challenging our choices in life is constantly increasing, while on the other hand, public health has a lot to learn in terms of presenting its own agenda, promoting it and disseminating it also through digital marketing strategies and tools. The book of abstracts collecting the contributions from the digital marketing workshop held in Ljubljana, organised by the National Institute of Public Health in collaboration with WHO, brings a range of important contributions. They aim at strengthening the methodologies used by public health in various strategies. The main focus is the impact on developing a healthy lifestyle and preventing NCDs, starting from children. The approach of building capacity and enabling public health professionals of adopting adequate methodologies, which would help them assume a more active role in digital marketing, seems to be an important gain the process. Modernising public health approaches means also developing knowledge, means and methodologies in using IT, social media and other strategies in addressing the challenges posed by the unhealthy lifestyles and the growing problem of NCDs, which is the main global challenge. Workshop in Ljubljana and this volume represent an important contribution to this process and I have no doubt that public health professionals will make good use of the collected materials in this book. Dr. Tit Albreht National Institute of Public Health Slovenia 1 The Book of Abstracts “Digital marketing to children - Methodological challenges for linking public health silos” brings us 7 abstracts and slides on important results, insights and ideas about common methodological grounds in digital marketing, digital “natives”, comparative analyses of digital marketing and public health perspectives. Digital marketing is an increasingly important public health issue and lifestyle determinant. Children across Europe use digital media avidly and increasingly. In 2012, 15-year-olds in the countries of the Organisation for Economic Co-operation and Development (OECD) reported using the Internet for nearly 2 h daily (109 min) on weekdays and an extra half an hour daily at weekends. Although data on this topic is currently limited, some studies by researchers and digital media actors globally confirm that children engage with and enjoy digital marketing. Digital technologies such as the internet, social media and video games use the rapidly evolving practice of marketing and advertising, including personal data collection, high- frequency stimulus, intensive emotional manipulation etc. Children and adolescents are especially vulnerable and unaware of the magnitude of influence of digital marketing and data extraction. Therefore, they should be supported and empowered to safely engage in the digital world to fulfil their rights to information and participation under the United Nations Convention on the Rights of the Child. At the end of the book, there are some further action that could be applied on the EU level, such as clear regulation, the protection of children, raising public awareness, improving digital media literacy etc. Dr. Helena Jeriček Klanšček National Institute of Public Health Slovenia 2 1 Introduction Digital marketing is one of the important determinants of health and it is linked to all lifestyle areas which, directly or indirectly, public health is dealing with, therefore a multidisciplinary competences and participatory approaches are needed. National institute of public health of Slovenia (NIJZ) launched a Digital marketing initiative and together with WHO Country Office in Slovenia organized a capacity-building workshop 2017 on Digital marketing to children - Methodological challenges in linking public health siloses. A capacity building workshop aim was to define how to proceed in the area of digital marketing, by exploring common methodological grounds in digital marketing in different lifestyle areas, to be able to discuss possible common holistic approaches. By going beyond each individual lifestyle area there is an opportunity to increase broad understanding of the problem of virtual reality and link potentials in public health. The workshop was attended by participants from the National Institute of Public Health (NIJZ), Ministry of Health of the Republic of Slovenia, Agency for Communication Networks and Services of the Republic of Slovenia (AKOS), Ministry of Health of the Slovak Republic, European Commission, WHO Country Office in Slovenia and WHO Regional Office for Europe, Directorate-General for Health and Food Safety (DG Sante), The Open University UK, EuroHealthNet, the Faculty of media in Ljubljana, Faculty of Social Sciences of the University of Ljubljana and Slovenian nongovernmental youth organization No-Excuse. Lectures on principles of digital marketing, legislative issues, presentation of experiences of the participating countries and possibilities for public health to act were followed by group work and round-table style discussions on recommendations for further steps. Dr. Mojca Gabrijelčič Blenkuš National Institute of Public Health Slovenia 3 2 Programme NIJZ and WHO Capacity building workshop 2017 on DIGITAL MARKETING TO CHILDREN Methodological challenges for linking public health siloses AGENDA Ljubljana, 12th October 2017 8.30 – 9.00 Registration Moderators of the workshop: Dr. Mojca Gabrijelčič, National Institute of Public Health Slovenia and Dr. Darina Sedláková, WHO Country Office for Slovenia 9.00 – 9.30 Welcome words and introduction Dr. Mojca Gabrijelčič, National Institute of Public Health Slovenia Vesna Petrič, Ministry of Health of the Republic of Slovenia Artur Furtado, European Commission - DG Sante Darina Sedláková, WHO Country Office for Slovenia 9.20 – 9.30 Roundtable introduction of the participants 9.30 – 10.30 Session 1 9.30 - 10.00 Digital marketing – a new determinant of a healthy lifestyle and NCDs in children – Jo Jewel, WHO Regional Office for Europe 10.00 - 10.40 Digital marketing as a lifestyle determinant – technical, ethical and nutritional challenges, Dr. Mimi Tatlow-Golden, Open University, UK 10.40– 10.55 Coffee and physical activity break 10.55 – 12.30 Session 2 10.55 – 11.15 Digital “natives” – how do they perceive digital marketing? No Excuse, Slovenia 11.15 – 11.20 Short comment from the communication perspective - Dr. Tanja Kamin, Faculty of Social Studies, University of Ljubljana 11.20 – 11.40 Digital marketing – how it works? Dr. Andrej Kovačič, Faculty of Media, Slovenia 11.40 – 11.45 Short statement on technological options in Slovenia: Petra Zupančič, Agency for communication networks and services of the Republic of Slovenia 11.45 – 12.05 Comparative analyses of (digital) marketing in different lifestyle areas – Dr. Mojca Gabrijelčič, National Institute of Public Health Slovenia 4 12.05 – 12.10 Short comment from inequalities perspective: Cristina Chiotan, EuroHealthnet 12.10 – 12.30 Questions and answers, reflections on the morning sessions 12.30 – 13.15 Lunch and physical activity break 13.15 – 16.45 Session 3 13.15 – 13.30 Wrap up morning sessions, guidance for the afternoon work – Dr. Mojca Gabrijelčič, National Institute of Public Health Slovenia 13.30 – 14.30 World-cafe/roundtable groups discussions on opportunities and challenges in the future, and enablers and inhibitory factors for capacity building (knowledge and human capacities) 14.30 – 15.00 Joint discussion on main outcomes of the group discussions 15.00 – 15.15 Coffee and physical activity break 15.15 – 16.00 Opportunities and barriers for policy interventions - Cristina Chiotan, EuroHealthnet 15.30 – 16.15 Interactive group discussion on future needs, possible future developments and possible measures 16.15 – 16.45 Discussion on the reporting back from the groups, formulation of the workshop recommendations 16.45 – 17.15 Recommendations, steps forward and conclusions of the workshop 5 3 Digital marketing – a new determinant of a healthy lifestyle and NCDs in children (Jo Jewel, WHO Regional Office for Europe) Abstract Jo Jewell (WHO Regional Office for Europe) presented on the work of WHO together with Member States in this area – covering work on alcohol, tobacco and food marketing. He started his presentation with a broad definition of marketing, and then focused more closely on marketing promotion (including, but not limited to product advertisement). He underscored the rationale for WHO working in this area, notably that marketing effects preferences, behaviours and consumption of products that cause harm for health. The approach across alcohol, tobacco and food may differ, with sometimes slightly different policy objectives (e.g. restricting food marketing to children and adolescents, rather than adult population). The various WHO policy frameworks were described, notably the European Action Plan for the Prevention and Control of NCDs 2016-2025, which clearly calls for the use fiscal policies and marketing controls to full effect to influence demand, access and affordability for tobacco, alcohol and HFSS foods and drinks. The challenge, as WHO understands, is how to ensure implementations is supported through comprehensive restrictions. This is where digital marketing can present some specific challenges, with academic literature questioning whether existing measures implemented are “fit for purpose” in closing loopholes for digital marketing. Additionally, it was discussed whether countries are addressing issues of digital marketing in silos and not cross-sectorally. WHO calls for a comprehensive response to the challenge of digital marketing for tobacco, alcohol and HFSS foods. Offline protections should logically be extended online. This will require a clear definition of the types of marketing covered and how this is applied in practice through legislation or other policy means. Additionally, action on internet marketing – by its nature cross-border – lends itself particularly well to EU level action (e.g. EU Directive on tobacco advertising and sponsorship). Key Sources:  WHO Regional Office for Europe, 2016. Tackling food marketing to children in a digital world: trans-disciplinary perspectives. Children’s rights, evidence of impact, ethodological challenges, regulatory options and policy implications for the WHO European Region. [e- publication]. Copenhagen: WHO Regional Office for Europe. Accessible at : http://www.euro.who.int/__data/assets/pdf_file/0017/322226/Tackling-food- marketing-children-digital-world-trans-disciplinary-perspectives-en.pdf [1 October 2017]. 6  WHO Regional Office for Europe, 2016. Action Plan for the Prevention and Control of Noncommunicable Diseases in the WHO European Region. [e-publication]. Copenhagen: WHO Regional Office for Europe. Accessible at: http://www.euro.who.int/__data/assets/pdf_file/0008/346328/NCD-ActionPlan- GB.pdf?ua=1 [1 October 2017].  WHO Regional Office for Europe, 2015. European Food and Nutrition Action Plan 2015– 2020. [e-publication]. Copenhagen: WHO Regional Office for Europe. Accessible at: http://www.euro.who.int/__data/assets/pdf_file/0003/294474/European-Food- Nutrition-Action-Plan-20152020-en.pdf?ua=1 [1 October 2017]. 7 Presentation 8 9 10 11 12 13 14 15 16 17 4 Digital marketing as a lifestyle determinant – technical, ethical and nutritional challenges (Dr. Mimi Tatlow-Golden, Open University, UK ) Abstract Dr Tatlow-Golden presented findings from a study for the Irish Heart Foundation (IHF), Who's Feeding the Kids Online? Digital food marketing and children in Ireland (https://www.irishheart.ie/wp- content/uploads/2016/12/web__whos_feeding_the_kids_online_report_2016.compressed. pdf) and the WHO study of which she was one of the lead authors, Tackling food marketing to children in a digital world: trans-disciplinary perspectives (http://www.euro.who.int/__data/assets/pdf_file/0017/322226/Tackling-food-marketing- children-digital-world-trans-disciplinary-perspectives-en.pdf) Dr Tatlow-Golden first pointed to the children's rights context in which the IHF and WHO reports were situated and articulated the gaps in current regulation identified by the WHO report. She pointed to the nature of the design of digital and particularly social media and the ways in which this presents challenges both to children and young people to resist negative effects as well as to regulators to address these. These media are currently designed to be (a) addictive, (b), to extract data (c) for these data to be used to target advertising to the more vulnerable. The new advertising ecosystem is a vast and complex network in which data from all internet users (including children) is taken to personalise advertising. This is increasing the reach of unhealthy advertising and helping advertisers to target those who are most vulnerable to their messages. In particular adolescents are not protected by most regulation and they are treated as adults online. However, they consume a large amount of digital media and are developmentally not well suited to resisting advertising, for biological, social and identity-related reasons. The Facebook “reach” of the 113 food brands most popular in retail sales and on Facebook among users aged 13 or 14 years in Ireland was identified in the IHF study (Facebook was chosen as it was the most viewed digital platform among teens in Ireland at the time, although indications now are that Instagram and Snapchat predominate). All 18 brands that Facebook estimated had the greatest “reach” in this age group featured sugar-sweetened carbonated drinks, fast foods, savoury snacks, sweets, chocolate and ice-cream. Content analyses found they used tactics of engagement, emotion and entertainment. Most frequent – more so than displaying the logo, packaging or advertised items– were prompts to interact 18 with ads: hashtags and invitations to like, comment and share, indicating brands’ desire that adolescents would spread marketing through their networks. The IHF study also examined the awareness of parents in Ireland to digital food advertising. As in other countries, parents had very low awareness of this form of advertising and their ideas about it were out of date ('pop-up ads', etc). At the end of the study three—quarters of parents favoured regulation of these forms of advertising, demonstrating the importance of building public awareness regarding advertising in digital media. Dr Tatlow-Golden considered whether the 'conversation' about regulating digital media may be changing in a context where politicians in the US and Europe are increasingly aware of the impact social media has (and external actors may have) on voting patterns. Finally she asked 3 questions:  Privacy and targeting: Why is extraction, storage, sale of personal data and targeted advertising legally permitted for under-18s?  Children/youth are frequently positioned as ‘knowing subjects’ when consuming food, data and digital privacy information. Where is the evidence that this is the case?  Differential susceptibility is critical. Vulnerability is washed out in studies reporting whole-group effects of food marketing. Key Sources:  WHO Regional Office for Europe, 2016. Tackling food marketing to children in a digital world: trans-disciplinary perspectives. Children’s rights, evidence of impact, ethodological challenges, regulatory options and policy implications for the WHO European Region. [e- publication]. Copenhagen: WHO Regional Office for Europe. Accessible at: http://www.euro.who.int/__data/assets/pdf_file/0017/322226/Tackling-food- marketing-children-digital-world-trans-disciplinary-perspectives-en.pdf [1 October 2017].  Tatlow-Golden, M., Tracey, L., Dolphin, L., 2016. Who's Feeding the Kids Online? Digital food marketing and children in Irelan. [e-publication]. Dublin: Irish Heart Foundation. Accessible at: https://www.irishheart.ie/wp- content/uploads/2016/12/web__whos_feeding_the_kids_online_report_2016.compresse d.pdf [1 October 2017].  UNICEF UK, 1989. The United Nations Convention on the Rights of the Child. [e- publication]. London: UNICEF UK. Accessible at: https://downloads.unicef.org.uk/wp- content/uploads/2010/05/UNCRC_united_nations_convention_on_the_rights_of_the_c hild.pdf?_ga=2.90691993.247602409.1516626405-900999715.1516626405 [1 October 2017].  WHO Regional Office for Europe, 2015. WHO Regional Office for Europe nutrient profile model. [e-publication]. Copenhagen: WHO Regional Office for Europe. Accessible at: http://www.euro.who.int/__data/assets/pdf_file/0005/270716/Nutrient-children_web- new.pdf [1 October 2017]. 19  Logicalis UK, 2016. The age of digital enlightenment. Logicalis Realtime Generation Report 2016. Slough: Logicalis UK. Accessible at: http://www.uk.logicalis.com/globalassets/united-kingdom/microsites/real-time- generation/realtime-generation-2016-report.pdf [1 October 2017].  Tatlow-Golden, M., Verdoodt, V., Oates, J., Jewell, J., Breda, J. and Boyland, E., “in print”. A safe glimpse within the “black box”? Ethical and legal principles when assessing digital marketing of food and drink to children. Public Health Panorama: journal of the WHO Regional Office for Europe, [e-publication] 4 (3). 20  Presentation 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 5 Digital “natives” – how do they perceive digital marketing? (Urška Erklavec, MPharm, Daša Kokole, MPsy, No Excuse Slovenia) Abstract The aim of the research was to preliminary explore young people's experiences with the digital world and their perceptions of the digital marketing. Data was obtained with 5 focus groups in the groups of 15 to 19 year old students. Participants are mainly using the social networks such as Facebook, Instagram, Snapchat and Youtube. Most of the participants are not aware of the technical background of the digital environment. When asked about separation between online and real world, the participants showed awareness that what one presents online are often only the positive events, which can skew other people's perception of real world. Majority of participants saw online world as a means of communication that enables them to meet and socialize in real life. Participants are aware of the possibility of leaving your digital information for others to see. As negative sides participants mentioned loss of actual privacy, as well as loss of feeling of security and privacy, and use of available information by other parties (e.g. advertisers). Participants generally noticed marketing in the digital environment, most commonly in forms of Instagram ads, Youtube advertisement before a video is shown, pop-up ads. Some find that disturbing and some are also aware that the ads that are being shown to them influence them wanting the product. Often mentioned was also the influence of cookies and how they are influencing (personalizing) the ads that are being shown to them. There was some difference between younger and older participants, with younger participants having an opinion that online marketing should be regulated, whereas the older participants were of an opinion that such regulation would be very hard as the companies will always find another way. Additionally they thought more can be done on individual level, by using services such as Ad blocker and educating yourself about the topic and being aware of when you are a target of advertising. Age restrictions (on Facebook) were not seen as useful, as they (and many other young people) can set their age to anything (so they can use facebook even before they are 13). In general, participants thought digital marketing is an important topic. On one hand they are aware of potential benefits (e.g. making shopping easy), but on the other hand they also see it as intrusive and having potential negative consequences. Key Source:  Preliminary study with focus groups 42 Presentation 43 44 45 46 47 48 49 50 6 Digital marketing – how it works? (Dr. Andrej Kovačič, Faculty of Media, Slovenia) Abstract With advanced communication techniques described in this presentation, professionals create and anchor pleasant feelings on the brand name they promote. Regardless whether stimulus anchoring comes in a form of sponsorship, direct ads or product placement, children are programmed to spend more time and become more addicted to media trance in order to get more and more commercially oriented hypnotic suggestions. The „battle“ for young consumers intensifies on the internet, where regulation is scarce and with the advances in technology more and more aggressive emotional excitement is aroused in younger and younger children. High frequency stimulus, intensive emotional manipulation and deep trance phenomena are used by professionals on subconscious level to target individuals and their weaknesses. Unfortunately children, parents, communities and regulators are unaware of the magnitude of influence and data extraction (in creating a consumer profile) and (or) feel helpless preventing it. First, we urgently need official recommendation for (future) parents and teachers regarding the recommended screen exposure - especially for the youngest. We have to provide quality education on the subliminal techniques used in marketing. Finally, we also need to balance commercial (unhealthy) marketing with substantial and professionally created healthy lifestyle advertising. We have to make ACTION now - before people play virtual reality games on the back seat of a self-driving car unable to communicate to anyone else but a computer. The knowledge of advanced influence techniques has to be used to create a future society where people are not only programmed consumers with complete data profiles that is never deleted but also humans who are able to express their own opinions and emotions and thus live a quality life. Key Sources:  J. Rideout, V., G. Foehr, U. and F. Roberts, D., 2010 . Generation M2: Media in the Lives of 8- to 18-Year-Olds. [e-publication]. Menlo Park: Henry J. Kaiser Family Foundation. Accessible at: https://kaiserfamilyfoundation.files.wordpress.com/2013/04/8010.pdf [1 October 2017].  www.pismenost.si [1 October 2017]. 51 Presentation 52 53 54 55 56 57 58 7 Comparative analyses of (digital) marketing in different lifestyle areas (Dr. Mojca Gabrijelčič, National Institute of Public Health Slovenia, with inputs from Austria and Slovakia) Abstract Digital marketing to children is linked to a range of lifestyle factors public health is dealing with. By joining forces in all lifestyle areas, namely tobacco, alcohol, gaming and gambling, physical activity, nutrition and others, including mental health, public health could identify potentials and challenges broadly and define common goals and agendas more efficiently. Presentation is exploring the situation in Slovenia, Slovakia and Austria with regard to the following questions: (1) Are there any rules (regulation, coregulation, selfregulation) for reducing marketing pressure of the products to children in different lifestyle areas in the country? (2) If yes, what kind of rules does exist? What channels of marketing they do apply to? Do they apply also for digital marketing? If yes, what kind of digital marketing? (3) How successful are such rules for digital marketing in a specific lifestyle area? What are the main challenges (definition of target group, age limitation, criteria, distribution channels, data privacy, tracking, monitoring, ...) in digital marketing? (4) What are the key obstacles and key facilitators for improvement of the situation (reducing or restricting pressure) in digital marketing in specified lifestyle areas? (5) What are the most promising steps forward in (reducing or restricting) pressure in digital marketing in specified lifestyle areas? Comparative analysis of marketing approaches in different lifestyle areas in Slovenia, Slovakia and Austria is showing that traditional media are more regulated, selfregulated or coregulated than digital media. It is also observed that digital marketing in more traditional lifestyle factors, such as nutrition, tobacco and alcohol, is more regulated as in the new emerging ones, such as gaming and gambling. It seems that rules in restricting marketing specifically in physical activity lifestyle factor do not exist or are not detected. In general, fewer rules exist in the digital as in the real world. Distribution channels were detected as more challenging in implementation of rules for reducing or restricting pressure in digital marketing to children as the target group definition. The most challenging issues in digital marketing in different lifestyle areas to children are: (1) monitoring and evaluation violations of introduced restrictions, (2) online sales and advertising by companies HQ in the other countries, (3) marketing self-regulation is not successful, (4) the need for establishing a system, detecting monitoring and evaluation 59 marketing communication messages in all the media, including the world wide web and mobile applications, to guarantee a better surveillance. Multidisciplinary competence and participatory approach are needed. As the key inhibitory factors for reducing the pressure of digital marketing to children in different lifestlye areas were detected (1) non-existing or innapropriate (outdated) national and EU legislation, (2) missing political will or consensus to act, (3) profitability is more important than public health, (4) internet is a non-regulated territory. Key enabling factors to reduce presure of digital marketing to children could be (1) mobilisation of public opinion pools, (2) bringing forward consumers and citizens rights, (3) raising the awareness of consumers and citizens, (4) informing the general public about the health impacts of digital marketing and their consequences, (5) better intersectoral cooperation, (6) better international cooperation, (7) more comprehensive and effective prevention, field work, advisory services. Key Sources:  Restrictions on the Use of Alcohol Act (Official Gazette of the Republic of Slovenia, number 15/03 and 27/17)  Act Amending the Health and Hygiene Safety of Foodstuffs and Products and Materials Coming in Contact with Foodstuffs Act (Official Gazette of the Republic of Slovenia, number 42/02)  Restriction on the Use of Tobacco and Related Products Act (Official Gazette of the Republic of Slovenia, number 9/17 and 29/17)  School Meals Act (Official Gazette of the Republic of Slovenia, number 3/13)  Gaming Act (Official Gazette of the Republic of Slovenia, number 14/11, 108/12, 11/14 in 40/14)  Audiovisual Media Services Act (Official Gazette of the Republic of Slovenia, number 87/11 and 84/15)  Chamber of Advertising of Slovenia, 2009. Code of Advertising Practice of Slovenia. [e- publication]. Accessible at: http://www.soz.si/sites/default/files/soz_sok_slo.pdf [1 October 2017] 60 Presentation 61 62 63 64 65 66 67 68 69 70 71 72 73 8 Opportunities and barriers for policy interventions (Cristina Chiotan, EuroHealthnet) The policy interventions at the EU and national/regional level can be broadly divided into: - mandatory policy, i.e. legislation/directive or regulation; - voluntary policy/agreements, i.e. national level schemes of self and co-regulation. The national laws or EU Directives are enforced by controls applied by the public sectors for example, 20% limit of advertising time as mentioned in the EU Audio Video Media Services Directive (AVMSD). For this type of policy impact assessments and continuous monitoring are crucial for implementation. Among the voluntary agreements the most commonly used is the self and co-regulation involving commitments of the industry and other relevant stakeholders towards achieving specific objectives. Recommendations and guidelines are also often issued at EU level being proposed by the Commission and approved by the Council. Within the legislation the EU and countries can use economic/fiscal measures, such as: - Taxation: Taxing products or processes that are harmful, or reducing taxation of products that are beneficial; - Subsidies: financial support to SMEs or small enterprises that support/promote healthy products and services; - Fees and user charges- charging to punish deviations from the law/data protection, etc.; - Investments in Research and Development –improve knowledge on health impacts; - Investments in Education and Training (school, higher education/university, life-long learning) – investments in digital and commercial health literacy. Policy implementation can be supported through various actions/interventions of communication, marketing of education campaigns: - public reporting of deviations (i.e. disclosure about companies non-compliant) - social marketing - media campaigns - advice/information centers for adolescents and parents - provide information on digital health literacy and negative impacts. To ensure maximum implementation the legislative measures could be endorsed by economic/fiscal measures and accompanied by interventions and actions. An example of EU policy is represented by the new proposal of the European Commission to revise the AVSMD. Being driven by the need for a better balance of rules the proposal introduces flexibility when restrictions only applicable to TV are no longer justified. At the same time, it aims to ensure that consumers will be sufficiently protected in the on-demand and Internet world. While strengthening the country of origin principle (i.e. simplify the rules 74 to determine the country having jurisdiction) it establishes the obligation of the Member States to inform about what providers are under their jurisdiction and maintaining an up-to- date database to ensure transparency. In terms of commercial communications, it maintains the strict 20% limit on advertising time, but gives broadcasters more flexibility as to when ads can be shown, and allows more flexibility in putting product placement and sponsorship. In relation with the protection of minors, the proposed modifications aim at simplifying the obligation to protect minors against harmful content, with everything that 'may be harmful' should be restricted on all services and the most harmful content shall be subject to the strictest measures, such as PIN codes and encryption. In relation with protecting the most vulnerable the proposal encourages the adoption of self- and co-regulation for the existing rules seeking to protect the most vulnerable (alcohol advertising, fatty food, minors, etc.). A study on “Effectiveness of self- and co-regulation in the context of implementing the Audiovisual Media Services Directive (AVMSD)” published in 20161 have evaluated the application of principles in national schemes in relation with protection of minors from harmful audiovisual content television and in on-demand Audio Media Services and on commercial communication in both television broadcasting and in on-demand AMS. The study has identified and assessed 33 self- and co-regulatory schemes identified in 25 MS. The findings have shown that as regards participants, most participants were from industry with consumer and civil society groups often not represented. As regards the openness of participants there were rare cases where stakeholders felt excluded or information withheld, however the information was kept overall in a closed group. In terms of the good faith of participants, it was difficult to assess if real effort or commitment was made with no possibility to determine the capacity of each stakeholder involved. There was a good legal compliance in vast majority of schemes. In most of the schemes analysed there was an overall general policy goal with less SMART objectives and indicators and evaluate which made it difficult to evaluate the impact of the scheme. There was also a lack of systematic process for improvement, and often no monitoring systems in place with few systems which assessed regularly performance and impact or identify areas for improvement. The study concluded that national self of co-regulation schemes are often not formalised or established explicitly. There are no formal objectives, monitoring processes or evaluations 1 https://ec.europa.eu/digital-single-market/en/news/audiovisual-and-media-services-directive-self-and-co- regulation-study 75 which weakness their effectiveness and impact. Out of 33 schemes identified and evaluated only four best practice cases were identified that can confirm that effective self- and co- regulation schemes, which fulfil the essential criteria of well-functioning self and co- regulation can be very effective. Key Sources:  Directive 2010/13/EU of the European Parliament and of the Council of 10 March 2010 on the coordination of certain provisions laid down by law, regulation or administrative action in Member States concerning the provision of audiovisual media services (Audiovisual Media Services Directive). Accessible at: http://eur-lex.europa.eu/legal- content/EN/ALL/?uri=CELEX:32010L0013 [1 October 2017]  Panteia and VVA, 2016. Effectiveness of self-and co-regulation in the context of implementing the AVMS Directive. A study prepared for the European Commission DG Communications Networks, Content & Technology. Luxembourg: Publications Office of the European Union. Accessible at: https://ec.europa.eu/digital-single- market/en/news/audiovisual-and-media-services-directive-self-and-co-regulation-study [1 October 2017]  76 Presentation 77 78 79 80 81 82 83 84 9 Short statement on technological options in Slovenia (Petra Zupančič, Agency for communication networks and services of the Republic of Slovenia) Abstract Agency for communication networks and services of the Republic of Slovenia (AKOS) is an independent body, which regulates electronic media on the basis of the Media Act and the Audiovisual Media Services Act. The regulation/co-regulation of advertising to children in Slovenia applies exclusively in the field of traditional audiovisual (AV) media - television and radio. Social networks, internet platforms etc. are not defined as media according to current media legislation and therefore remain deregulated. Digital marketing is regulated only by self-regulatory codes. Co- regulation and self-regulation represent the future of the tendency to protect children from inappropriate advertising content in the digital world (in this direction also the current reform of the EU AVMS Directive), however individual countries report that the principle of self-regulation and voluntary codes do not produce the expected results. AKOS also presented the regulatory practices of the EU Member States for the AV commercial messages for HFSS food in children's program and for alcohol. There is no uniform regulatory practice. In the end, AKOS emphasized the role of regulatory agency in developing media/advertising literacy for children and adults - skills, knowledge and understanding, which enables effective and safe use of the media. Media education should be prioritized and placed in the school curriculum. AKOS’s practice and contribution is in accordance with comparable EU legislatory practice and its recommendations/baseline considerations/illuminations have substantial weight. KeySources:  Media Act (Official Gazette of the Republic of Slovenia, number 110/06, 36/08, 77/10, 90/10, 87/11, 47/12, 47/15, 22/16 and 39/1615/03)  Audiovisual Media Services Act (Official Gazette of the Republic of Slovenia, number 87/11 and 84/15) 85 Presentations Regulatory framework for advertising to children in (traditional) media (*in jurisdiction of the regulator for electronic media Agency for communication networks and services of the Republic of Slovenia (AKOS) on the basis of the Media Act and Audiovisual Media Services Act) → WHERE WE ARE: - (Co-)regulation of advertising to children exclusively in the field of traditional audiovisual (AV) media – television (TV) and radio (in accordance with current media legislation, social networks, internet platforms etc. are not defined as media and therefore remain deregulated; digital marketing is regulated by self-regulatory codes) – media regulation in relation to child protection in the field of advertising includes only of general principles regarding AV commercial messages and more specifically for high fat, salt, sugar (HFSS) foods (obligation per se) *see below ! issue: children are influenced by different media in different age periods – preschool children may be mainly addressed by TV, older children mainly move to other platforms (social networks, YouTube) → AV commercial messages to minors (product placement in content for children is not allowed; SEPARATION PRINCIPLE – advertising content clearly separated from other content) must not: ! issue: new, »soft« advertising techniques, e.g. »merchandising« – AV and food industry networking, »brand integration« – licensed cartoon characters in advertisements for HFSS food, »advergames«, »video advertising« etc. - cause physical, mental or moral damage - encourage them to buy or lease products due to their inexperience - encourage them to persuade their parents to buy advertised goods - show their peers in dangerous situations Stegne 7, P O B o x 418, 1001 Ljubljana, Tel: 01 583 63 00, Fax: 01 511 11 01, E-mail: info.box@akos-rs.si, www.akos-rs.si, T ax n u mb e r:10482369 0825 Regulatory framework for advertising to children in (traditional) media 86 - Provider of AV media service formulates the RULES OF CONDUCT regarding inappropriate AV commercial messages for HFSS food in/along children's program content, according to nutrition guidelines, announced by the minister for health. The provider must publish the Rules and forward them to the ministry, responsible for media, and to AKOS. ! issue: other programme content not primarily for children, although children represent an important proportion of the audience; broadcasted in time periods, when children follow the media, e.g. family films ! issue: HFSS food is still advertised to children, very small proportion of advertisement industry promotes healthy food (e.g. according to Consumers' Association of Slovenia 50 % of the advertised breakfast cereals in Slovenia contain more than 30g of sugar/100g of the product) ! issue: what is the purpose of showing text messages promoting healthy lifestyle in the programme (for children) together with advertisements for HFSS food → WHERE ARE WE GOING: - Co-regulation, self-regulation (collective responsibility; e.g. Code of Advertising Practice of Slovenia) – represent the future of tendency to protect children from inappropriate digital advertising (in this direction also the current revision of the Audiovisual Media Services Directive) ! issue: individual countries report that self-regulation and voluntary codes are not effective in achieving of the desired results ↓ MEDIA/ADVERTISING LITERACY – skills, knowledge and understanding that enable users to efficiently and safely use the media. Media regulators co-create web portals, cooperate with market stakeholders, support educational campaigns and awareness raising activities in educational institutions (for both children and teachers) – creating SCHOOL CURRICULUM in compliance with the competent authorities. New advertising techniques (»digital marketing« – SEPARATION PRINCIPLE no longer applies) – personalization, interaction, integration – »brand integration/placement«, »advergames«, »video advertising«, »advertising connected to social media« (profiled targeting, so-called online »influencer« – blogs, vlogs), online banner, virtual world itd. 825 Regulatory framework for advertising to children in (traditional) media 87 → their subtle and contextual (merging editorial content with advertising content) nature necessarily requires 1) an informed individual/child who recognizes sublimated forms of media messages that address him as a consumer, 2) on platforms that can not be regulated by traditional regulation measures → REGULATORY PRACTICE OF EU COUNTRIES – AV COMMERCIAL MESSAGES FOR HFSS FOOD IN CHILDREN'S PROGRAM (26/28 Member States): 1. Legal regulation/co-regulation – RULES OF CONDUCT regarding inappropriate AV commercial messages for HFSS food in/along children's program content (public broadcasting service and commercial media): - Austria (prohibition of any advertising in/directly before/after) - Belgium (French area) (conditionally in heath legislation gives the king the power to act) - Cyprus - Estonia - France (signed food agreement between publishers, advertisers and TV producers under the ministry of health, culture and media regulator; also an agreement on promotion of a healthy lifestyle – obligatory publication of the message on a healthy diet) - Germany - Romania (participation of celebrities in advertisements for children under the age of 12 years is not allowed; promotional advertisements for a healthy lifestyle) - Slovenia - Spain – It is not allowed to encourage consuming HFSS food by AV commercial messages (legal requirement): - Belgium (Flemish area) - Germany – AV commercial messages for HFSS food are not allowed in children's program: - Denmark (a ban on advertising within program content for children under the age of 13 years) 825 Regulatory framework for advertising to children in (traditional) media 88 - Ireland (allowed in other programs, but insofar as they addres children under certain conditions (see below) and to the maximum extent of 25% of advertising time; obligatory publication of the message on a healthy diet; ban on »pester power«; participation of celebrities for advertising purposes is not allowed) - Malta (30 min before and 30 min after children's program), - Poland, - Sweden (general ban on advertising to children) - Great Britain (absolute ban in/during/after children's programs, in specialized children's programs and in program content for children under the age of 16 years; obligatory publication of the message on a heathy diet; absolute ban on promotional placement; ban on »pester power«; in advertisements for preschool and primary school children no promotional offers are allowed; participation of celebrities for advertising purposes is not allowed) 2. Self-regulation – ADVERTISING/ETHICAL CODES OF AV MEDIA SERVICES PROVIDERS, ADVERTISERS, FOOD INDUSTRY: - Austria - Belgium (French area) - Belgium (Flemish area) - Bulgaria - Croatia - Cyprus - Czech Republic - Denmark (code of conduct applies for traditional and so-called new media) - Estonia - Finland - Germany (including digital marketing) - Greece - Italy - Ireland (only video on demand) - Latvia - Lithuania - Malta - Netherlands - Poland 825 Regulatory framework for advertising to children in (traditional) media 89 - Portugal - Romania - Slovakia (not specifically for children) - Spain → REGULATORY PRACTICE OF EU COUNTIRES – AV COMMERCIAL MESSAGES FOR ALCOHOL (23/28 Member States): *in jurisdiction of the media regulators 1. Absolute ban on alcohol advertising (with time exceptions): - Belgium (Flemish area) (before/after children's program) - Estonia (applies to public broadcasting service; for other providers, ban on advertising between 7.00 and 21.00) - France - Hungary (applies to public broadcasting service; absolute ban on advertising spirits between 18.30 and 21.30) - Lithuania (between 18.00 and 23.00) - Malta (between 6.00 and 21.00) - Nizozemska (between 6.00 and 21.00) - Poland (exceptions: beer between 20.00 and 6.00, sports program content) - Portugal (between 7.00 and 22.30) - Sweden - Great Britain (before/during/after the program for young audience) 2. Absolute ban on spirits advertising (with time exceptions): - Austria - Belgium (French area) (applies to public broadcasting service; provider who advertises alcohol must ensure broadcasting time to the same extent for preventive awareness raising campaigns) - Bulgaria (indirect advertising allowed after 22.00) - Germany - Finland (absolute ban on alcohol advertising between 7.00 and 21.00) - Ireland (absolute ban on alcohol advertising during/along children's program) - Italy (during/along children's program) - Latvia - Romania (between 6.00 and 22.00) 825 Regulatory framework for advertising to children in (traditional) media 90 - Slovenia - Spain (absolute ban on alcohol advertising between 6.00 and 20.30) *PRACTICE OF EU COUNTRIES, see more: https://www.dlapiper.com/~/media/Files/Insights/Publications/2016/12/3169756_UNICEF_Advertisi ng_To_Children_Update_V8.pdf → A few challenges for the future – which is already here: 1. MEDIA/ADVERTISING LITERACY – the role of the regulator in developing media literacy of both parents and children (web portal, workshops within the school curriculum, participation in awareness-raising campaigns, promotion of complaint tools etc.) 2. MEDIA EDUCATION – as a priority, classification of a compulsory school subject; curriculum needs to follow the development of advertising techniques and the level of exposure to advertising in individual age groups 3. (PROMOTION OF) HEALTHY EATING HABITS – the role educational system and media 4. While excessively regulating exclusively traditional media we forget, that children are more and more addressed by other deregulated internet platforms-new advertising forms whose broadcasting is unlimited in both scope and time. 5. Too strict requirements in the field of traditional media can lead to movement of advertisers to other, lesss regulated platforms. 6. Providers of AV media can create a better quality program (also) with the help of advertising resources. 7. Regulation of advertising to children in children program does not take into account program content with high proportion of children among the audience (e.g. family films) 8. Continuous and coordinated cooperation with clearly defined goals between the two holders of regulatory powers NIJZ and AKOS and other stakeholders. 825 Regulatory framework for advertising to children in (traditional) media 91 10 Conclusions and recommendations Setting the scene Preventing and controlling NCDs, as well as risk factors of NCDs, is one of the major development imperative for the 21st century (WHO, 2017). Since exposure to risk factors begins in childhood, protecting children from adverse impacts of marketing, including DM, is important for reducing risk factors for NCDs (WHO, 2013). Digital technologies, which are widely used by children across Europe, offer rapidly evolving practices of marketing and advertising, including personal data collection and emotional persuasion, to achieve greater advertisement attention, more positive brand attitudes, and higher product sales in comparison to traditional marketing platforms (e.g. broadcasting) (WHO, 2016). Current knowledge and public health approaches are not adequate for controlling (prevention, monitoring, counteracting) DM, therefore the NIJZ decided to launch a Digital marketing initiative. Capacity building workshop 2017 on Digital marketing to children - methodological challenges in linking public health siloses was organized by the NIJZ, and the WHO Country Office for Slovenia. The aim of this workshop was to define how to proceed in the area of digital and other types of marketing of different lifestyle risk factors to children with the following objectives: - to raise awareness and to build capacity for Slovene health promotion workforce in the area of DM; - to define common denominators for more efficient work in the area of DM of “lifestyle products” to children and adolescent in Slovenia; - to develop background materials and recommendations for the work in the area of DM to children in the future; - to contribute to the work of WHO in compiling evidence and best practices to tackle the growing problem of digital marketing to children. Lectures on principles of DM, legislative issues and technological options, presentation of experience of the participating countries and possibilities for public health action were followed by round-table discussions on recommendations for further steps. Participants have voted for ideas they considered most important. Ideas most commonly voted for were collected under the following subsections: ethics, governance and leadership, framing and regulation, capacity building, research, and call on immediate actions. They are presented below. 92 1. Ethics General need for further elaboration of ethical issues of DM was stressed. Lack of transparency on individuals’ information collection, analysis, selling, and ownership was pointed out as controversial, especially given the low level of awareness of persuasive techniques, inherent to DM, and the addictive nature of digital media. Social norms were recognized as the broader context of DM to children. Indeed, policy can support social norm changes by clearly stating their priorities, helping address even global problems (Nyborg et al, 2016). It was expressed that currently business interest (profit) is much stronger than public interest and that parents are more likely addicted to digital media as before, which could be among main inhibitory factors in the process of changing social norms related to DM to children. However, nongovernmental organizations (NGO) programmes focusing on personal development of children were identified as a key enabling factor. Putting focus on quality relationships, family life and common activities was recommended. 2. Governance and leadership Absence of specific dedicated working group addressing the problem of DM within institutional and political framework was recognized. Establishing an intersectoral body, responsible for framing DM, and putting the issue of DM into strategies and agendas of broad circle of institutions was recommended. Since DM is a global issue including various sectors, it was recommended to address it on the level of the UN. Public health was proposed to take over the leadership regarding the problematics of DM on national and international levels. 3. Framing and regulation Lack of recommendations and regulation in the area of DM to children was recognized. It was stressed that data collection, analysis, dissemination/selling and ownership should be transparent by the industry and that data extraction from minors should be limitted/stopped. The need for clear regulation of media marketing was recommended, especially regarding updated definitions in digital media and appropriate extension of rules for broadcasting also to digital media. 4. Capacity building More resources for governance and capacity building are needed to act effectively in this relatively new and challenging area. In turn, organized civil society groups will be stimulated to gain and disseminate knowledge to the general public. It was pointed out, that general 93 public is unaware of subliminal messages, present in the content of DM, and their addictive nature. Raising public awareness and improvement of digital literacy of children, parents, teachers, etc. (possibly placed in the school curriculum), and empowerment of parents and future parents through education about possible harms due to DM to children was recommended. 5. Research Lack of knowledge on DM, its techniques, and impacts was recognized. Research results and knowledge dissemination to a broad range of experts and audiences is vital. 6. Call on immediate actions As a general recommendation, it was stressed, that even if we lack sufficient knowledge on the problematics of DM, we should immediately start taking action that follow from the above recommendations. Equally important is monitoring and evaluating these actions as ongoing. 7. Conclusions and recommendations of the workshop Immediate action is needed to frame DM to children, which would among others include: - establishing an inter-sectoral body; - providing more capacities and resources for public health actions in the area of digital marketing, together with increasing multidisciplinary competences; - further elaboration ethical issues; - ensuring transparency of personal data extraction, storage, sale, and ownership in the digital media, and limit emotionally persuasive and/or addictive techniques and/or targeted advertising of DM, especially for minors; - developing clear regulation on digital marketing; - raising public awareness and improving digital media literacy; - stimulating research fully characterising the digital marketing children are exposed to and noting their differential susceptibility. 94 11 References Nyborg K, Anderies NM, Dannenberg A, Lindahl T, Schill C, Schlüter M et al. Social norms as solutions. Science 2016; 354: 42–43. World health organization. Major NCDs and their risk factors (http://www.who.int/ncds/introduction/en/). World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. WHO, 2013 (http://www.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf?ua=1). World Health Organization. Tackling food marketing to children in a digital world: trans- disciplinary perspectives. WHO Regional Office for Europe, 2016 (http://www.euro.who.int/data/assets/pdf_file/0017/322226/Tackling-food-marketing- children-digital-world-trans-disciplinary-perspectives-en.pdf). A number of references are included in the presentations. 95