The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/2042-6763.htm
JSOCM
12,2
174
Received 12 April 2021
Revised 12 May 2021
21 September 2021
9 December 2021
Accepted 13 December 2021
Journal of Social Marketing
Vol. 12 No. 2, 2022
pp. 174-190
© Emerald Publishing Limited
2042-6763
DOI 10.1108/JSOCM-04-2021-0077
Genetic nutrition programmes –
disappointment or empowered
health? Exploring consumer
engagement to understand social
health change
Denise Maria Conroy
Department of Consumer Insights, Plant and Food Research Ltd.,
Auckland, New Zealand
Amy Errmann
Department of Marketing, The University of Auckland Business School,
Auckland, New Zealand
Jenny Young
Plant and Food Research Ltd., Auckland, New Zealand, and
Ilaisaane M.E. Fifita
Department of Marketing, The University of Auckland Business School,
Auckland, New Zealand
Abstract
Purpose – This research aims to gain insight into how consumers interact with a commercially available
genetic nutrition programme, DNAfit, to explore health change via an intervention.
Design/methodology/approach – Focus groups were conducted between June and October 2019, pre-,
during- and post-intervention, with a total sample of 14 younger (aged 25–44 years) and 14 mature (aged 45–
65 years) cohorts from New Zealand. Qualitative thematic analysis was completed with the help of NVivo software.
Findings – Younger participants in this study engaged less overall with DNAfit, felt the service did not match
their lifestyles and did not encourage their believability of genetic personalised nutrition (GPN). In contrast,
mature participants had positive engagement with GPN, as their motivation to use the service fit with their
motivation for longevity. Overall, social uptake in health changes based on GPN is likely to depend on life stage.
Originality/value – This paper adds to limited social marketing research, which seeks novel avenues to
explore how consumers engage with GPN technologies to drive social change, assisting social marketers on how
to more effectively deliver health programmes that allow consumer-driven interaction to build health capabilities.
Keywords Public health, Health promotion, Social marketing, Consumer engagement,
Digital intervention, Personalised nutrition, Social health change
Paper type Research paper
Funding: Financial support for the conduct of the research was obtained from the University of
Auckland Food and Health Programme Seed Funding and the Performance Based Research Fund
(PBRF) from the Department of Marketing, University of Auckland. These funding sources had no
involvement in any aspect of this study, such as the study design, data collection, analysis or
interpretation, report writing or decisions on submission for publication.
1. Introduction Genetic
In the past decade, a novel health programme introduced to consumers is genetic nutrition
personalised nutrition (GPN), which uses an individual’s DNA to build a personalised health
plan (Floris et al., 2020). Similar to other modern health programmes, such as Fitplan or
programmes
MyFitnessPal, GPN is delivered through digital applications (apps) (Michel and Burbidge,
2019). The aim of GPN is to evolve social health change from broad population-based
guidelines (e.g. food pyramids) to individualised genetic recommendations (e.g. diet plans)
(Adams et al., 2020). GPN is important to social marketing as the uptake of individual 175
“roadmaps” of diet, nutrition and exercise set GPN apart from health “fads” that may not
change health behaviour (Celis-Morales et al., 2017; Chaudhary et al., 2021). As genomic
science is at the forefront of social change in medicine, biotechnology and bioengineering
(Galimberti et al., 2019), so too may the unique health programmes of GPN facilitate social
change in marketing (Szak
aly et al., 2021). In this vein, GPN may be recognised as an
empowerment tool to promote health behaviour in consumers (Besson et al., 2020),
delivering on broad social change (Carvalho and Mazzon, 2015).
However, although GPN is becoming increasingly important in social health research
(Fenech, 2019), GPN programmes remain a niche activity and are not yet mainstream among
consumers (Szak
aly et al., 2021). Further, the lion’s share of marketing research has explored
consumer acceptance of GPN (Poínhos et al., 2018; Kiss, 2019; Stewart-Knox et al., 2019;
Reinders et al., 2020), whereas research on how consumers engage with GPN programmes
remains limited (Rusu et al., 2020). Initial evidence exists that consumers may make changes
if they receive GPN advice (Jinnette et al., 2021). However, research has yet to unveil the
motivations, beliefs and actual health behaviour uptake of consumers who actively engage
with a GPN programme.
The current research aims to provide insights into how consumers engage with GPN
during and after a live intervention using an available GPN programme, DNAFit. Through
the pairing of a live intervention and a series of focus groups, we shed light on how
consumers use personalised health technologies to drive social change through exploring
their engagement. Further, we assist social marketers on how to use GPN as a tool for social
good by more effectively delivering health programmes to consumers who may use them.
We present consumer insights that, on the one hand, view GPN as an empowering frontier in
health programmes whereas, on the other hand, it is viewed as a disappointing ineffective
trend.

2. Background
2.1 Social marketing and consumer health change
Individual behaviour change is the seminal core of social marketing (Andreasen, 2002) and
the success of social health programmes (Besson et al., 2020). In this vein, programmes are
provided with the assumption that consumers voluntarily follow recommendations and are
responsible for the programme’s social impact (Wymer, 2011). However, the results of a
blanketed upstream approach to social health change have led to a phenomenon wherein a
“one-size-fits-all” approach of health recommendations, such as nutrition labelling or food
pyramids, is provided as a generalised system to consumers for changing health behaviours
(Chaudhary et al., 2021). This results in a barrier of broad health programmes that exhibit an
overly universal approach to making effective health changes (Xia et al., 2016).
A broad-systems approach to social marketing neglects the personal social environment
of a consumer (Lefebvre, 2011), such as changes in their access to technology, that leave the
consumer empowered with tools to enhance changes in their lives (Amar et al., 2020). The
current research moves away from broad-systems upstream marketing to a consumer-
JSOCM oriented capability-driven approach. In this way, we view behaviour change as an engaged
12,2 and enabled change, wherein consumers are active participants who shape interaction with
the targeted social change (Saunders et al., 2015).
Therefore, we view social change as a socially entwined engagement between consumers
and producers and consider individuals as active participants in social change marketing
(Fry et al., 2017). We look to digital tools that empower consumers to become active
176 participants in their own change (Manikam and Russell-Bennett, 2016). Exploring digital
tools via live interventions has been increasing; however, understanding what engages
consumers with digital health devices remains limited (Besson et al., 2020). Therefore,
understanding how consumers engage with digital-based GPN programmes becomes
important to understand possibilities for social health change.

2.2 Consumer engagement in digital age

Specific to digital health change, engagement is viewed as an active network of interactions
between consumers, applications and organisations (Besson et al., 2020). Moreover, van
Doorn et al. (2010) specified engagement as a dynamic and connected state between
consumers and organisations. In this way, the consumer has evolved from a passive
individual to an active participant who is central to activating social health change (Michel
and Burbidge, 2019). Considering consumer engagement as a dynamic interaction, we adopt
the operationalisation that consumer engagement relies on interaction with health
technologies to change health behaviour (Michel and Burbidge, 2019). In the current
research, the DNAFit programme becomes a platform to explore how consumers engage
with the service to understand the influence on health change.

2.3 Consumer acceptance of genetic personalised nutrition

Previous research suggests that consumers overall have mixed attitudes towards GPN
(Mullins et al., 2020). For instance, a recent study showed that approximately 23% of survey
respondents accept GPN, while other studies have shown about 50% of respondents would
accept and use a GPN service (Stewart-Knox et al., 2013). Further, mixed attitudes are
observable through different demographics. Ahlgren et al. (2013) found that younger people
are more willing to accept GPN, while in contrast, other research has found that mature age
groups are more willing to accept GPN (Stewart-Knox et al., 2013). Differences are also seen
by country, with consumers in Britain (38%) and Italy (38%) the highest in acceptance and
Germany among the lowest (13%) (Stewart-Knox et al., 2009).
However, prior research has recently been viewed as too broad, looking at acceptance
among populations (Floris et al., 2020) rather than pinpointing specific barriers or opportunities
among targeted sets of consumers (Jinnette et al., 2021). More recent research tells us that
consumers with specific health needs, such as anaemia, have better updates in adopting GPN
(Lee et al., 2020). Also, consumers may have more responsibility in managing their health,
which is more appealing (Michel and Burbidge, 2019). However, in contrast, GPN technologies
may be hard to understand and interpret, leading to misuse or low adoption (Vesnina et al.,
2020). Ambivalent feelings or an inappropriate diet context has also been shown to reduce
intentions to use GPN in consumers (Reinders et al., 2020). Such lack of adoption has also been
attributed to inconsistent implementation of GPN services (Adams et al., 2020). Overall, prior
research has explored the broad acceptance of GPN, while more current research has examined
specific health benefits, resulting in research on consumer engagement with GPN being
significantly low (Szak
aly et al., 2021). There is a need to go beyond general acceptance to
understand how consumer groups engage with the technology to determine its health change
impact (Michel and Burbidge, 2019).
3. Methods Genetic
3.1 Study design nutrition
A digital app intervention (Manikam and Russell-Bennett, 2016) was layered with process
evaluation focus groups (Mitchell and Branigan, 2000) at the pre-, during- and post-
programmes
intervention stages. Focus groups consisted of two primary age cohorts (see subsection 3.4)
and the total intervention for each cohort took place over 12 weeks. Focus groups paired
with health technology interventions were the most appropriate design, as focus groups 177
play a crucial evaluative role when engaging with health programme interventions (Mitchell
and Branigan, 2000). The methods and procedures of the study, including informed consent,
were approved by the University of Auckland Human Participants Ethics Committee.

3.2 Intervention technology

The use of the DNAfit service allowed us to examine engagement with a commercially
available GPN product. DNAfit is a service that provides health, nutrition and well-being
DNA-based individual factors to create a health programme for each app user (DNAfit,
2019). DNAfit was selected for being a real digital service that the participants could use in
their everyday lives (Celis-Morales et al., 2017). This allowed the participants to freely
engage with the service during their free time and report their observations back to the focus
groups, which has proven to be a successful process in similar studies (Nour et al., 2018).
Further, DNAfit’s data privacy overcomes a key consumer barrier of the anxiety of data
ethics (Stewart-Knox et al., 2013). DNAfit protects privacy and destroys DNA samples after
analysing (DNAfit, 2019).
In the first focus group (pre-invention), our participants discussed their initial
expectations of GPN services. They received their own DNAfit kit (free of charge), activated
their private account in the digital app and provided a saliva swab. The participants
received their results approximately 10 days after swabbing by logging into their personal
accounts. We subsequently initiated the second focus group two weeks after and a third
focus group eight weeks later. Participants were advised they could disclose as much or as
little of their results as they desired. The app interface is presented in Figure 1(a)–1(i).

3.3 Focus group procedure

The use of focus groups supported the unearthing of important themes of consumer
engagement with GPN, allowing for open-ended probing of discourses (Giles and Brennan,
2015). This protocol was established based on guidelines for process evaluation focus
groups in grounded research (Mitchell and Branigan, 2000), where the conversation was left
open-ended for exploratory discussion of the group.
Each cohort had a pre-intervention focus group to understand expectations, a during-
intervention group to understand initial responses and a final post-intervention group, to
assess longer-term usage (Needleman and Needleman, 1998). Conducting separate focus
groups pre-, during- and post-intervention is seen to be adequate in working towards a point
of saturation (Carlsen and Glenton, 2011). In total, 12 focus groups were conducted, after
which the researchers conferred and agreed that no new information was emerging in the
discussions, and therefore, no further focus groups were initiated.
Focus groups took approximately 1 h, were audiotaped and subsequently transcribed.
Each focus group was conducted with three researchers: a primary moderator who asked
open-ended questions, a research associate who made notes and monitored the interview
process and a research assistant who triangulated the notes (Krueger, 2014).
JSOCM
12,2

178

Figure 1.
Examples of the
DNAfit app interface
and services

3.4 Participants
Recruitment took place using snowball sampling methods that began with the researchers’
networks. No participants had any major health issues or significant symptoms of disease.
Participants were provided with a detailed “Participant Information Sheet”, which outlined the
aims of the study and the information that would be collected. Informed consent was obtained
from each participant prior to the commencement of the fieldwork. There were two primary
groups: a younger cohort (aged 25–44 years) and a mature cohort (aged 45–65 years). Both had
separate male and female subgroups, with participants having a range of occupations (Table 1).

3.5 Data collection and analysis

Transcripts of the focus group were analysed using a phased thematic analysis process to
identify themes and patterns in the data (Braun and Clarke, 2006). Pre-, during- and post-
intervention data were coded separately. Initial codes were generated by one researcher using
inductive coding (Hennink et al., 2011) to search for themes which were verified by the principal
investigator and two other research associates, in accordance with triangulation (Carlsen and
Glenton, 2011). The researchers then reviewed and refined the final themes for the report.

4. Results
In general, there were divergent responses and amounts of engagement between the
younger and mature cohorts, with males and females expressing similar viewpoints. Table 2
highlights six emergent themes and eight sub-themes among the age cohorts: motivation Genetic
(life stage and diets), viability (lived intuition), believability (user experience), engagement nutrition
(platform interaction), adoption (short vs long term) and perceived availability (social
change and price). The themes table (Table 2) provides short quotes that highlight key
programmes
descriptions between each age cohort. These themes are discussed in detail within the next
section, with illustrative quotations appearing in italics.
179
4.1 Motivation: life stage
The underlying motivations to engage with GPN emerged as a notable difference between
the younger and mature cohorts in all the initial focus groups. Initially, the younger cohort
demonstrated aspirational motivations to use the service. Still, this motivation was
dependant on whether DNAfit could provide a “magic bullet” and support an efficient and
convenient path to health.
It could make your diet much more efficient. Normally the blanket approach is just try any one
and see [. . .] the benefit of personalising it is you might get that push to do something that’s much
more efficient and easy to become healthier. (Veronica, younger female)

It’s going to be this holy-grail that’s going to identify all these things that are making me fat.
(Doug, younger male)
However, after receiving results, expectations of the “magic bullet” approach were unmet
and motivation dwindled. The younger males and females did not engage in-depth with the
service, for example, by reading all the available information, going through the application
or making diet or nutrition changes. This was due to a busy lifestyle that is dominant within
individuals who are establishing adulthood. Those starting careers and families felt that
their motivation was low because their lifestyles got in the way.
It’s a phase thing, you know, sometimes I’m busy and stressed and tired, and I don’t care, and I’ll
just eat. (Dan, younger male)

I do things that fit into my life, so I don’t always exercise [. . .] I just can’t be bothered now. (Sally,
younger female)
In opposition, the mature cohort was at a life stage where their primary motivation was
healthy longevity. This influenced their motivation to ensure they had taken advantage
of DNAfit and what there was to learn about the service. This cohort noted that any
change they could make to better their health was worth trying, and thus, they had a

Groups No. of participants Occupations

Cohort 1 – young cohort n=8 Audio Engineer (2); Film Production Assistant; Software
Male, aged 25–44 years Developer (2); Retail Worker; Social Media Analyst (2)
Female, aged 25–44 years n=7 PhD Student (2); Science Administrator (2); Social Media
Analyst (2); Homemaker
Cohort 2 – mature cohort
Male, aged 45–65 years n=6 Finance Executive; Builder; Cameraperson; Other White
Collar (2); Retired
Female, aged 45–65 years n=7 Lecturer (2); Homemaker (2); Retired; Research Co-Ordinator; Table 1.
Office Manager Participant
Total participants n = 28 characteristics
 12,2

180

themes
Table 2.
JSOCM

Emergent key
Motivation Viability Believability
Life stage Diets Lived intuition User experience
Younger Mature Younger Mature Younger Mature Younger Mature

“It’s a phase “Health and “There was “I’m all for plant- “I don’t need a “Confirmed what I had “Feeling rather cynical” “It is very
thing” exercise are a no option for based protein” DNA test to tell grown to know” impressive”
priority” a vegetarian” me to eat more
broccoli”
“I can’t be “This reinforced a “Completely “I’m paying a lot “Making these “The intuition is there” “They have errors” “I would say
bothered now” lot” impractical” of attention” results less it exceeded
certain” expectations”
Engagement Adoption Perceived availability
Platform interaction Short vs long term Social change Price
Younger Mature Younger Mature Younger Mature Younger Mature
“It sounds like “I don’t see why “It almost “My changes are “Different “We’re all different. . . “In my life stage I don’t “Ya, I think
they just want to this shouldn’t be has that kind already in place” benefits for individualised have $300 to spend on the price
control it” in the hands of of horoscope different age programmes are the this” point is
everybody” effect” groups” way” about right”
“Are they trying “I think that’s “All pretty “Yeah, I’ve done “You have to “All information is “I just don’t think I have “It’s not
to sure up their gatekeeping” obvious everything!” make sure lower valuable across all age any dietary conditions. . . knowledge
revenues?” stuff” income can groups” that I think it would you can get
access it” benefit from” elsewhere”
reason to be motivated to engage with the service. This was obvious at the pre- Genetic
intervention stage, as there was an initial reason to believe in the scientific merit if it nutrition
could help with longevity.
programmes
When you’re 20, you do whatever you like because you’re indestructible – but as you get over 50,
you start to really notice that things just don’t move the same. So, you start focusing on what you
eat, and exercise. (Bob, mature male)
181
Health and exercise are a priority, whereas never used to be a priority [. . .] the emphasis now is on
what makes you feel best. (Lisa, mature female)
These responses continued to filter through to the post-intervention stage, influencing how
viable they thought the service was towards changing their behaviours. Even if both cohorts
thought that following the DNAfit recommendations could alter their health, the younger
cohort deemed the motivations to make changes were not pressing at this stage of life, and
there was no imperative to do so.
Timing, I just couldn’t figure out a time to do that. Or just too many other things on [. . .] the
information it gave, there was a lot of information [. . .] I didn’t feel like I needed to know more.
(Liam, younger male)

I haven’t done much. I felt like there hasn’t been much kind of extra room to concentrate on diet
and changing habits now. (Emma, younger female)
In opposition, the mature cohort remained motivated throughout the post-intervention stage
to engage with the service and use the recommended changes ad hoc to fit into their
lifestyles. Because the group was already motivated by longevity, the changes they needed
to make were minimal, as health seemed to already be a focus for this group. Further, the
group was very aware of their motivation due to their age, mentioning that they had the
time and resources to be able to make use of a personalised programme that matched what
they were searching for in their life stage.
Afraid that I’m going to die in my 50s [. . .] I try and look at different diets and different fitness
regimes. And yeah, this just reinforced a lot of stuff that I had thought I already knew but was
helpful to have this sort of scientific approach. (Jack, mature male)

If you’re not working and you’ve got all day to be able to create healthy, nutritious food, great
[. . .] I think nutrition and food is very linked to your particular circumstances. (Sophia, mature
female)

I feel as though I need to make dietary change to avoid illness in later years. I am pleased with the
results and any change in behaviour is my choice. This is based on my personal data so it is a
targeted programme. (Lisa, mature female)
Overall, it was evident in the younger cohort that there was an inherent lack of motivation to
engage with DNAfit due to lifestyle. In contrast, the mature cohort had more “skin in the
game” through a desire to enhance longevity. Thus, engagement with GPN relied on
differences in motivation between opposing life stages.

4.2 Motivation: diets

A dominant theme across all cohorts was the belief in selective diets that were more ethical.
It was clear that due to human impact on the environment, changes in our diets would
ultimately need to be made. Future foods, such as meat-free alternative protein options and
JSOCM new farming technologies, were all equally likely to be adopted by the younger and mature
12,2 cohorts, even though they were not highlighted by the DNAfit service.
Particularly in our household I think environmentally, health wise, as well as animal welfare – we
are trying to actively reduce the amount of meat we eat. (Sally, younger female)

I’m paying a lot of attention to that (environment) and I’d like to think that most of us around the
182 world will accept that. (Lenny, mature male)

I’m all for plant-based protein [. . .] I honestly believe if we can produce food in a more
environmentally sustainable way – that for me is a drawcard. (Lisa, mature female)
Primarily for the younger cohort, one of the significant drawbacks of DNAfit was that
lifestyle diet was not taken into account in their individual genetic-based plan. The service
did not inquire whether someone only ate fish, plant proteins or was allergic to any foods.
Instead, the service would provide eating plans for one’s genotype, resulting in vegans being
told to eat a high animal protein low carb diet if their biomarkers indicated so. This left
dissonance within the participants, as a personalised service built on their biomarkers
would tell them to behave in a way that opposed their ethical lifestyle. For these
participants, this resulted in a lack of motivation to engage with the service, as it did not
cater to an individualised lifestyle. Thus, this placed importance on understanding how
GPN services can reconcile the chosen lifestyle of individuals rather than have a lifestyle fit
to genotype.
There was no option for a vegetarian meal plan [. . .] I thought that suggesting a Mediterranean
diet was very old fashioned. (Rachel, younger female)

The meal plan that I downloaded is completely impractical for a family. There was no recognition
that fruit and vegetables are seasonal. (Courtney, younger female)

4.3 Viability: lived intuition

During the intervention stage, the participants’ intuition between the DNAfit results
received and whether the results matched their lived experience acted as a barrier or conduit
to the viability of DNAfit. The younger groups overall had a confirmation bias in which they
used their intuition as a rationale to bypass changes that were recommended by the service.
This seemed to become more salient in the later post-intervention stage and acted as a driver
to disbelieve the results. Many participants mentioned a granular result that did not match
with their intuition and, therefore, coloured the total experience for them.
I know what is and isn’t good for me based on personal experience, I don’t need a DNA test to tell
me to eat more broccoli! [. . .]. I think partly because all the results were “normal” after years of
suspected susceptibility to lactose and gluten, and a definite intolerance of alcohol. I have issues
with certain foods, so I immediately questioned the validity of these results. (Dan, younger male)

I didn’t know that I’m lactose intolerant. For me it’s a surprise because I never feel something
when I drink milk. Maybe my genes are telling me something, but my body figured out how to
digest the milk, making these results less certain. (Jen, younger female)
There was, however, a different response from the mature cohorts who had more lived
experience than the younger cohort. They could find intuitive factors that matched the
service, therefore building viability of health changes and, ultimately, believability towards
the technology because it matched their experience.
 Did this result at my current age surprise me? No, I suppose I’d put it back to just life experience. Genetic
(Mitch, mature male)
nutrition
It’s sort of 50/50, the intuition is there but the learning (DNAfit) of course sparks new thoughts. programmes
(Pete, mature male)

It mostly gave me information that I knew about myself but just confirmed what I had grown to
know about myself over time, as far as diet and exercise goes. (Julia, mature female) 183
It confirmed some of the things that I thought about myself, like coeliac predisposition. (Sylvia,
mature female)

4.4 Believability: user experience

It was evident across all cohorts that the user interface impacted their believability of
the GPN results post-intervention. This was also related to prior motivation and
viability influences. Specifically, the younger cohort found the user interface non-
friendly. This resulted in a more sceptical user experience and a resulting lack of
believability.
I must admit to feeling rather cynical about the whole design. I was expecting it to feel more
science-based [. . .] It then made me not take the science information too seriously, and I lost
interest. This was like reading fancy horoscopes someone had posted on Facebook, rather than
solid fact-based science. (Dan, younger male)

They have errors (on the App) and it kind of strips validity from the science. (Rachel, younger
female)
However, for the mature groups, the user interface and technology of the application seemed
appealing and prompted believability in GPN science. This was also influenced by prior
motivation to engage and belief in the viability of the service to work for them.
It is very impressive and for me. I think the quality of the infographic is awesome [. . .] it’s your
DNA, you can’t change it, you know. (Mitch, mature male)

I would say it exceeded expectations. I read all the documents and then it made sense once you
read all the documents. (Ella, mature female)

I liked the presentation of the results and that graphic, I thought it was really effective. I thought
it was really believable. (Grace, mature female)

4.5 Engagement: platform interaction

Another driver that influenced engagement was the type of hypothetical interaction the
participants were asked to consider – either through a dietician, individually or in a social
group setting. Firstly, groups had similar distinctions when the moderator introduced the
idea that GPN may need to be regulated and consulted through dieticians to be properly
interpreted; all groups voiced that the service should be available to the public to be used as
they wanted without the monitoring of a health authority.
If I had some kind of fire engine company, that would be me saying that people shouldn’t be
allowed to have hoses in their house. It sounds like they just want to control it so they can make
more money. (Doug, younger male)
JSOCM Are they trying to prevent harm from people, or are they trying to sure up their revenues? It
doesn’t seem very harmful. (Emma, younger female)
12,2
I don’t see why this shouldn’t be in the hands of everybody. Because then you can actually go “I
need to drop down to one donut a month instead of one a day.” And I mean I think it’s helpful.
(Bob, mature male)
184 I think that’s gatekeeping to be honest, for it to just go through dieticians. (Julia, mature female)
When prompted about individual usage versus group usage of the product (as the
participants had all been a part of focus groups during-intervention), both cohorts noted that
an individual experience might have prompted them to be less comparative, while noting
that social discussion supported an understanding of the contrast between results.
If you were at that point in your life where you chose to purchase this product individually, I
think that could potentially be very different. (Rachel, younger female)

If they’ve got this virtual platform creating that, you know, those virtual rooms whereby you can
compare and contrast. (Mitch, mature male)

I actually feel better in a way, because knowing that there is diversity in them. (Lily, mature female)

Yeah, it was definitely interesting to hear other people’s results and it sort of made you think
about your own results a bit more. (Ella, mature female)

4.6 Adoption: short vs long term

All members of the younger groups disengaged with the service post-intervention.
Ultimately, this lag in engagement seemed to emerge from the initial lack of motivation, a
lack in viability in that the change behaviours were not actionable and the scepticism of
believability to the service.
It almost has that kind of horoscope effect where you start reading other people’s and you realise
they all kind of apply to you. (Doug, younger male)

I mean I think everything that my results suggest is all pretty obvious stuff, you know. Just eat less
sugar, eat more vegetables, it’s kind of like what everyone should probably do. (Dan, younger male)

Realistically you could go on any type of healthy eating plan and cut out the worst, refined sugars
and lose some weight. (Veronica, younger female)

I’m a bit sceptical really, I kind of suspect that there will be groups of people, you fit into this
category so you get this one, and you get that one because you fit into that category. (Courtney,
younger female)

Nothing motivates you to follow the diet – yeah, I needed a carrot. The carrot and the stick. (Jen,
younger female)
In contrast, the mature groups had made some changes to their diet and had engaged with
the service more, indicating long-term engagement. However, because the mature groups
were initially more motivated to make life changes, believed in the viability of individualised
health advice and believed in the service, they seemed to be already focussed on behaviour Genetic
changes, meaning the long-term changes adopted by GPN did not have to be drastic. nutrition
I’ve started buying a mix of broccoli to add to my salads. I’ve cut out the meat that I needed to do, programmes
according to DNAfit. Apart from that I haven’t really changed too much. My changes are already
in place. (Jack, mature male)

I think I went back to what I was doing before, so that was positive. (Sylvia, mature female) 185
Yeah, I’ve done everything! They said I should be following a low carb diet which just confirmed
what I’d been thinking, because I was sort of actively doing it. (Sophia, mature female)

4.7 Perceived availability: social change

Finally, a discussion around social change emerged about whether the service was helpful
for broad society. Most groups did believe that GPN is beneficial for health change, with
limited opposing discourse.
Different benefits for different age groups. The younger, they’re more in tune with environment
and all that sort of stuff. And then also just with the older ones, just the health consciousness
factor of it. (Doug, younger male)

I think all information is valuable across all age groups. (Pete, mature male)

There’s not a one-size-fits-all, we’re all different, so to have a food guideline, you know, how can
they be applicable to everybody? So, I think the individualised programmes are the way to go.
(Julia, mature female)
However, some participants voiced that while GPN is a more available programme, when
compared against more expensive or time-consuming alternatives, it may still not be
available to vulnerable groups.
Rather than having to shell out not only for a nutritionist but also for a personal trainer, that’s just
something that I wouldn’t be able to do. (Rachel, younger female)

I think this could be useful to change people’s health, but you have to make sure lower income can
access it. (Dan, younger male)

4.8 Perceived availability: price

It was apparent that the younger cohorts did not see the service as something they would
engage with due to the limited disposable income.
I wouldn’t probably have done it if it was my money. I think I don’t really have any dietary or
physical conditions that I think it would benefit from. (Ben, younger male)

I just don’t think in my life stage I have a spare $300 bucks to spend on this. (Nora, younger
female)

Yeah, I think the price points about right, because if it was, you know, lower you might be a little
more dismissive, you know, of the science. (Mitch, mature male)

Yeah, I think so. It’s not knowledge you can get anywhere else, not easily. (Julia, mature female)
JSOCM This indicated that younger cohorts might not desire a GPN service unless they had a
12,2 specific initial goal attached. However, in contrast, the mature cohorts voiced their response
that the price is worth the value for the service and that they would use it if faced with the
purchase opportunity.

5. Discussion
186 Initially, all participants voiced expectations of DNAFit being a “magic bullet,”, offering
convenient and efficient recommendations. However, differences emerged between the
younger and mature cohorts. Similar to Stewart-Knox et al. (2009), mature age groups
showed more positive attitudes towards GPN. However, in contrast to Ahlgren et al. (2013),
we did not see positive attitudes from the younger cohort. Participants attributed this to life
stages, as younger age groups focussed on building their life during their 20 s and 30 s, while
mature groups prioritised longevity. The younger group had less motivation to engage in
the service, while the mature group had enhanced motivation. If consumers are going to be
motivated to engage with the technology, GPN needs to be tailored across age groups to
appropriate life stages (Stewart-Knox et al., 2013; Szak
aly et al., 2021).
Further, results revealed the limitation of the programme to be integrated into alternative
diets (e.g. veganism). For participants, the fact that the service was not customised to their
life choices resulted in the perception of a one-size-fits-all approach, even though the point of
the service was designed to enhance the opposite effect. Like previous research, the pursuit
of a healthy diet for some consumers seems to be enough, and personalised GPN would not
be needed for them (Fallaize et al., 2013). We saw this illuminated with our younger cohort,
while in opposition, the mature cohort felt GPN to be more effective than general nutrition
recommendations (Ronteltap et al., 2007). Ultimately, this tells the story that individuals
consume foods as a lifestyle, not just nutrients (Michel and Burbidge, 2019). The exclusion of
the “culture” of eating seemed to be a significant shortcoming of the service. Reconciling
genetic science that focusses on nutrient needs alongside cultural lifestyle choices needs to
be considered.
The viability of changes was perceived differently by age. Mature groups had already
made changes to their diet based on what “felt right” over their lifespan, while the younger
cohort felt there were shrinking options of what they could eat (Nordström et al., 2013).
Given this critical attitude, it may be advisable for GPN providers to create different
presentations of results by age, e.g. narrow results for mature age groups for consistency
and more flexible choices for younger age groups with shifting work, diet and life schedules.
In general, although all of the cohorts voiced that GPN is most likely scientifically
“believable”, user experience influenced whether they wanted to continue. This has been
shown in other studies, in which the user interface was imperative to the overall adoption of
the nutrition technology (Nour et al., 2018). For example, the interface had a direct impact on
how many vegetables participants would eat. If it is desired that consumers take control of
their health, the ease of access and engagement of the service are guardrails that influence
health changes. In other words, if the mobile website or app is not believable, there is little
reason to believe in the health science it delivers.
Overall, the use of digital interventions to enable social health change is an increasingly
important topic for research in social marketing (Besson et al., 2020). The current study
contributes to this domain by identifying how consumers use GPN health technologies. We
found that overall, younger participants viewed GPN as a disappointing ineffective trend. In
contrast, mature participants viewed GPN as an empowering frontier in health change,
showing that engagement is likely to depend on factors of age differences. If there is indeed
a “carrot-and-stick” to engage with the service, the carrot needs to be different for the Genetic
younger and mature age groups to ensure health changes are made. nutrition
programmes
6. Implications for social change
Implications for social health change rest on the perception of GPN to either be too broad or
has the “goldilocks” (just being perfect) effect, which influenced the health changes of
participants. The younger cohort attributed the “horoscope” effect to GPN, in that if you
genuinely believed your results, they could be valid for anybody. Conversely, the mature
187
groups felt there was honest diversity within their results. Some studies have shown that
“personalised” advice is often regarded as “common sense advice” (Ahlgren et al., 2013),
mirroring the outcomes of the younger cohort. In contrast, alternative research has
demonstrated that GPN is much more enjoyable and easier to understand than general
health advice (Fallaize et al., 2013).
The younger groups viewed the price point of the product to be a possible barrier of
accessibility, while the mature cohort viewed a higher price point to endow the product with
more believability. This is in accordance with previous research that stated consumers with
the highest income classes and most motivation to use the service are willing to pay higher
prices for PN (Ahlgren et al., 2013). Further, research has suggested that the price of GPN
plays a role in the attitudes towards the service, in that attitudes are more positive, and
believability is higher with premium price points (Stewart-Knox et al., 2013). This may pose
a problem for society, in that only those with disposable income would be able to access and
afford the service, leaving those with lower incomes unable to afford the service.
Furthermore, social systems are complex, and often, lower income classes or unrepresented
consumers often struggle with obesity and health issues (Parkinson et al., 2017), creating the
need for the availability of GPN for all income classes to be an important social
consideration point for marketers and organisations.
The positioning of GPN by social marketers needs careful consideration. As a premium
product marketed as providing individual health advice, the lack of engagement with an
individual’s dietary choices (e.g. vegetarianism) and lifestyles (e.g. working mother with
three children) seems erroneous. Equally, there appears to be a lack of sophisticated
understanding of the target market; with such extreme differences found between the older
and younger cohorts, it would seem advisable to target both differently. The mature market
was far more engaged with the product, while the younger cohort craved gamification, chat
rooms and other familiar to their generation aspects, with which they can identify. For GPN
to gain and maintain traction in the wider market, these somewhat basic market positioning
features will need to be addressed.

7. Limitations and future research

A limitation of this study was that participants did not pay for the DNAfit service. Some
participants mentioned that this might have had an influence on their engagement in that
they took results for granted due to the lack of personal financial input. Secondly, it should
be noted that data was obtained in group settings. While participants received their results
in an individual setting, they were aware of their involvement in a group study. As most
GPN services using mobile technology are individual, different outcomes may have
emerged. However, to obtain valuable initial insights, focus groups were seen as the most
appropriate method (Mitchell and Branigan, 2000).
Regarding future research, it would be interesting to explore participants’ experiences
with the digital content as textual representations of dietary descriptions. Therefore,
exploring e-reading as one factor that influences engagement would be of interest.
JSOCM Finally, it would be of great interest to continue studies with more diversity between
12,2 participants to understand if the results would vary. The current study included European
participants aged 25–65 years. This may have limited the variety of the gene-based results,
as the group was European Caucasian. In the future, we would like to include different
groups such as those with Asian or Polynesian ethnicity.

188 References
Adams, S.H., Anthony, J.C., Carvajal, R., Chae, L., Khoo, C.S.H., Latulippe, M.E., Matusheski, N.V.,
McClung, H.L., Rozga, M., Schmid, C.H. and Wopereis, S. (2020), “Perspective: guiding principles
for the implementation of personalized nutrition approaches that benefit health and function”,
Advances in Nutrition (Bethesda, Md.), Vol. 11 No. 1, pp. 25-34.
Ahlgren, J., Nordgren, A., Perrudin, M., Ronteltap, A., Savigny, J., van Trijp, T., Nordström, K. and
Görman, U. (2013), “Consumers on the internet: ethical and legal aspects of commercialization of
personalized nutrition”, Genes and Nutrition, Vol. 8 No. 4, pp. 349-355.
Amar, M., Gvili, Y. and Tal, A. (2020), “Moving towards healthy: cuing food healthiness and appeal”,
Journal of Social Marketing, Vol. 11 No. 1, pp. 44-63.
Andreasen, A.R. (2002), “Marketing social marketing in the social change marketplace”, Journal of
Public Policy and Marketing, Vol. 21 No. 1, pp. 3-13.
Besson, M., Gurviez, P. and Carins, J. (2020), “Using digital devices to help people lose weight: a
systematic review”, Journal of Social Marketing, Vol. 10 No. 3, pp. 289-319.
Braun, V. and Clarke, V. (2006), “Using thematic analysis in psychology”, Qualitative Research in
Psychology, Vol. 3 No. 2, pp. 77-101.
Carlsen, B. and Glenton, C. (2011), “BMC medical research methodology full text what about N a
methodological study of sample-size reporting in focus group studies”, BMC Medical Research
Methodology, Vol. 11 No. 1, pp. 1-10.
Carvalho, H.C. and Mazzon, J.A. (2015), “A better life is possible: the ultimate purpose of social
marketing”, Journal of Social Marketing, Vol. 5 No. 2, pp. 169-186.
Celis-Morales, C., Livingstone, K.M., Marsaux, C.F., Macready, A.L., Fallaize, R., O’Donovan, C.B.,
Woolhead, C., Forster, H., Walsh, M.C., Navas-Carretero, S. and San-Cristobal, R. (2017), “Effect
of personalized nutrition on health-related behaviour change: evidence from the Food4Me
European randomized controlled trial”, International Journal of Epidemiology, Vol. 46 No. 2,
pp. 578-588.
Chaudhary, N., Kumar, V., Sangwan, P., Pant, N.C., Saxena, A., Joshi, S. and Yadav, A.N. (2021),
“Personalized nutrition and -Omics”, Comprehensive Foodomics, (January), pp. 495-507.
DNAfit (2019), “DNAFit: About”, available at: www.dnafit.com
Fallaize, R., Macready, A.L., Butler, L.T., Ellis, J.A. and Lovegrove, J.A. (2013), “An insight into the
public acceptance of nutrigenomic-based personalised nutrition”, Nutrition Research Reviews,
Vol. 26 No. 1, pp. 39-48.
Fenech, M. (2019), The Role of Nutrition in DNA Replication, DNA Damage Prevention and DNA Repair,
Principles of Nutrigenetics and Nutrigenomics: Fundamentals of Individualized Nutrition, Elsevier Inc.
Floris, M., Cano, A., Porru, L., Addis, R., Cambedda, A., Idda, M.L., Steri, M., Ventura, C. and Maioli, M.
(2020), “Direct-to-consumer nutrigenetics testing: an overview”, Nutrients, Vol. 12 No. 2, pp. 1-13.
Fry, M.L., Previte, J. and Brennan, L. (2017), “Social change design: disrupting the benchmark
template”, Journal of Social Marketing, Vol. 7 No. 2, pp. 119-134.
Galimberti, A., Casiraghi, M., Bruni, I., Guzzetti, L., Cortis, P., Berterame, N.M. and Labra, M. (2019),
“From DNA barcoding to personalized nutrition: the evolution of food traceability”, Current
Opinion in Food Science, Vol. 28, pp. 41-48.
Giles, E.L. and Brennan, M. (2015), “Changing the lifestyles of young adults”, Journal of Social Genetic
Marketing, Vol. 5 No. 3, pp. 206-225.
nutrition
Hennink, M., Hutter, I. and Bailey, A. (2011), “Data preparation and developing codes”, Qualitative
Research Methods, SAGE, London, pp. 201-229.
programmes
Jinnette, R., Narita, A., Manning, B., McNaughton, S.A., Mathers, J.C. and Livingstone, K.M. (2021),
“Does personalized nutrition advice improve dietary intake in healthy adults? A systematic
review of randomized controlled trials”, Advances in Nutrition, Vol. 12 No. 3, pp. 657-669.
Kiss, M. (2019), “Consumer acceptance of personalized nutrition”, Trends in Personalized Nutrition,
189
pp. 225-260, doi: 10.1016/B978-0-12-816403-7.00009-X.
Krueger, R.A. (2014), Focus Groups: A Practical Guide for Applied Research, Sage publications, New York, NY.
Lee, Y., Yang, N., Shin, M., Lee, K.E., Yoo, C.H. and Kim, K. (2020), “The effects of a personalized
nutrition intervention program on food security, health and nutritional status of low-income
older adults in Seoul city”, Journal of Nutrition and Health, Vol. 53 No. 4, pp. 416-430, doi:
10.4163/JNH.2020.53.4.416.
Lefebvre, R.C. (2011), “An integrative model for social marketing”, Journal of Social Marketing, Vol. 1
No. 1, pp. 54-72, doi: 10.1108/20426761111104437.
Manikam, S. and Russell-Bennett, R. (2016), “The social marketing theory-based (SMT) approach for
designing interventions”, Journal of Social Marketing, Vol. 6 No. 1, pp. 18-40, doi: 10.1108/
JSOCM-10-2014-0078.
Michel, M. and Burbidge, A. (2019), “Nutrition in the digital age – how digital tools can help to solve the
personalized nutrition conundrum”, Trends in Food Science and Technology, Vol. 90, (October
2018), pp. 194-200, doi: 10.1016/j.tifs.2019.02.018.
Mitchell, K. and Branigan, P. (2000), “Using focus groups to evaluate health promotion interventions”,
Health Education, Vol. 100 No. 6, pp. 261-268, doi: 10.1108/09654280010354887.
Mullins, V.A., Bresette, W., Johnstone, L., Hallmark, B. and Chilton, F.H. (2020), “Genomics in
personalized nutrition: can you ‘eat for your genes’?”, Nutrients, Vol. 12 No. 10, pp. 1-23, doi:
10.3390/nu12103118.
Needleman, C. and Needleman, M.L. (1998), “Qualitative methods for intervention research”, American
Journal of Industrial Medicine, Vol. 29 No. 4, pp. 329-337.
Nordström, K., Juth, N., Kjellström, S., Meijboom, F.L., Görman, U. and Food4Me Project (2013), “Values
at stake: autonomy, responsibility, and trustworthiness in relation to genetic testing and
personalized nutrition advice”, Genes and Nutrition, Vol. 8 No. 4, pp. 365-372, doi: 10.1007/
s12263-013-0337-7.
Nour, M.M., Rouf, A.S. and Allman-Farinelli, M. (2018), “Exploring young adult perspectives on the use
of gamification and social media in a smartphone platform for improving vegetable intake”,
Appetite, Vol. 120, pp. 547-556, doi: 10.1016/j.appet.2017.10.016.
Parkinson, J., Dubelaar, C., Carins, J., Holden, S., Newton, F. and Pescud, M. (2017), “Approaching the
wicked problem of obesity: an introduction to the food system compass”, Journal of Social
Marketing, Vol. 7 No. 4, pp. 387-404, doi: 10.1108/JSOCM-03-2017-0021.
Poínhos, R., Oliveira, B.M., Van Der Lans, I.A., Fischer, A.R., Berezowska, A., Rankin, A., Kuznesof, S., Stewart-
Knox, B., Frewer, L.J. and De Almeida, M.D. (2018), “Providing personalised nutrition: consumers’ trust
and preferences regarding sources of information, service providers and regulators, and communication
channels”, Public Health Genomics, Vol. 20 No. 4, October, pp. 218-228.
Reinders, M.J., Bouwman, E.P., Van Den Puttelaar, J. and Verain, M.C. (2020), “Consumer acceptance of
personalised nutrition: the role of ambivalent feelings and eating context”, PLoS One, Vol. 15
No. 4, pp. 5-8, doi: 10.1371/journal.pone.0231342.
Ronteltap, A., Van Trijp, J.C.M., Renes, R.J. and Frewer, L.J. (2007), “Consumer acceptance of
technology-based food innovations: lessons for the future of nutrigenomics”, Appetite, Vol. 49
No. 1, pp. 1-17, doi: 10.1016/j.appet.2007.02.002.
JSOCM Rusu, A.V., Penedo, B.A., Bethke, M., Schwarze, A.K. and Trif, M. (2020), “Smart technologies for
personalized nutrition and consumer engagement (Stance4health Eu H2020 – Funded project)”,
12,2 Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. Food
Science and Technology, Vol. 77 No. 1, p. 97, doi: 10.15835/buasvmcn-fst:2019.0012.
Saunders, S.G., Barrington, D.J. and Sridharan, S. (2015), “Redefining social marketing: beyond
behavioural change”, Journal of Social Marketing, Vol. 5 No. 2, pp. 160-168, doi: 10.1108/JSOCM-
03-2014-0021.
190 Stewart-Knox, B., Gibney, E.R., Abrahams, M., Rankin, A., Bryant, E., Oliveira, B.M. and Poínhos, R.
(2019), “Personalized nutrition: making it happen”, Trends in Personalized Nutrition, pp. 261-276,
doi: 10.1016/b978-0-12-816403-7.00010-6.
Stewart-Knox, B.J., Bunting, B.P., Gilpin, S., Parr, H.J., Pinhao, S., Strain, J.J., de Almeida, M.D. and
Gibney, M. (2009), “Attitudes toward genetic testing and personalised nutrition in a
representative sample of European consumers”, British Journal of Nutrition, Vol. 101 No. 7,
pp. 982-989, doi: 10.1017/S0007114508055657.
Stewart-Knox, B., Kuznesof, S., Robinson, J., Rankin, A., Orr, K., Duffy, M., Poínhos, R., de Almeida, M.
D.V., Macready, A., Gallagher, C. and Berezowska, A. (2013), “Factors influencing European
consumer uptake of personalised nutrition. Results of a qualitative analysis”, Appetite, Vol. 66,
pp. 67-74, doi: 10.1016/j.appet.2013.03.001.
Szak
aly, Z., Kov
acs, B., Szak
aly, M., Nagy-Peto†, D.T., Popovics, P. and Kiss, M. (2021), “Consumer
acceptance of genetic-based personalized nutrition in Hungary”, Genes and Nutrition, Vol. 16
No. 1, doi: 10.1186/s12263-021-00683-7.
van Doorn, J., Lemon, K.N., Mittal, V., Nass, S., Pick, D., Pirner, P. and Verhoef, P.C. (2010), “Customer
engagement behavior: theoretical foundations and research directions”, Journal of Service
Research, Vol. 13 No. 3, pp. 253-266.
Vesnina, A., Prosekov, A., Kozlova, O. and Atuchin, V. (2020), “Genes and eating preferences, their roles
in personalized nutrition”, Genes, Vol. 11 No. 4, doi: 10.3390/genes11040357.
Wymer, W. (2011), “Developing more effective social marketing strategies”, Journal of Social
Marketing, Vol. 1 No. 1, pp. 17-31, doi: 10.1108/20426761111104400.
Xia, Y., Deshpande, S. and Bonates, T. (2016), “Effectiveness of social marketing interventions to
promote physical activity among adults: a systematic review”, Journal of Physical Activity and
Health, Vol. 13 No. 11, pp. 1263-1274, doi: 10.1123/jpah.2015-0189.

Further reading
Roosen, J., et al. (2008), “Consumer demand for personalized nutrition and functional food”,
International Journal for Vitamin and Nutrition Research, Vol. 78 No. 6, pp. 269-274, doi: 10.1024/
0300-9831.78.6.269.

Corresponding author
Amy Errmann can be contacted at: a.errmann@auckland.ac.nz

For instructions on how to order reprints of this article, please visit our website:
www.emeraldgrouppublishing.com/licensing/reprints.htm
Or contact us for further details: permissions@emeraldinsight.com