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Delaney T, Wyse R, Yoong SL, Sutherland R, Wiggers J, Ball K, Campbell K, Rissel C, Lecathelinais C, Wolfenden L. Cluster randomized controlled trial of a consumer behavior intervention to improve healthy food purchases from online canteens. Am J Clin Nutr 2017; 106:1311-1320. [PMID: 28971849 DOI: 10.3945/ajcn.117.158329] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/30/2017] [Indexed: 11/14/2022] Open
Abstract
Background: School canteens represent an opportune setting in which to deliver public health nutrition strategies because of their wide reach and frequent use by children. Online school-canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer-behavior strategies that have an impact on purchasing decisions.Objective: We assessed the efficacy of a consumer-behavior intervention implemented in an online school-canteen ordering system in reducing the energy, saturated fat, sugar, and sodium contents of primary student lunch orders.Design: A cluster-randomized controlled trial was conducted that involved 2714 students (aged 5-12 y) from 10 primary schools in New South Wales, Australia, who were currently using an online canteen ordering system. Schools were randomized in a 1:1 ratio to receive either the intervention (enhanced system) or the control (standard online ordering only). The intervention included consumer-behavior strategies that were integrated into the online ordering system (targeting menu labeling, healthy food availability, placement, and prompting).Results: Mean energy (difference: -567.25 kJ; 95% CI: -697.95, -436.55 kJ; P < 0.001), saturated fat (difference: -2.37 g; 95% CI: -3.08, -1.67 g; P < 0.001), and sodium (difference: -227.56 mg; 95% CI: -334.93, -120.19 mg; P < 0.001) contents per student lunch order were significantly lower in the intervention group than in the control group at follow-up. No significant differences were observed for sugar (difference: 1.16 g; 95% CI: -0.50, 2.83 g; P = 0.17).Conclusions: The study provides strong evidence supporting the effectiveness of a consumer-behavior intervention using an existing online canteen infrastructure to improve purchasing behavior from primary school canteens. Such an intervention may represent an appealing policy option as part of a broader government strategy to improve child public health nutrition. This trial was registered at www.anzctr.org.au as ACTRN12616000499482.
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Affiliation(s)
- Tessa Delaney
- Hunter New England Population Health, Wallsend, New South Wales, Australia; .,School of Medicine and Public Health and.,Priority Research Center for Health Behavior, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Rebecca Wyse
- Hunter New England Population Health, Wallsend, New South Wales, Australia.,School of Medicine and Public Health and.,Priority Research Center for Health Behavior, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Wallsend, New South Wales, Australia.,School of Medicine and Public Health and.,Priority Research Center for Health Behavior, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Wallsend, New South Wales, Australia.,School of Medicine and Public Health and.,Priority Research Center for Health Behavior, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Wallsend, New South Wales, Australia.,School of Medicine and Public Health and.,Priority Research Center for Health Behavior, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Victoria, Australia; and
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Victoria, Australia; and
| | - Chris Rissel
- New South Wales Office of Preventive Health, South West Sydney Local Health District, Liverpool Hospital, Liverpool New South Wales, Australia.,Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | | | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia.,School of Medicine and Public Health and.,Priority Research Center for Health Behavior, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Delaney T, Wyse R, Yoong SL, Sutherland R, Wiggers J, Ball K, Campbell K, Rissel C, Wolfenden L. Cluster randomised controlled trial of a consumer behaviour intervention to improve healthy food purchases from online canteens: study protocol. BMJ Open 2017; 7:e014569. [PMID: 28416500 PMCID: PMC5541437 DOI: 10.1136/bmjopen-2016-014569] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/21/2017] [Accepted: 02/15/2017] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION School canteens represent an opportune setting in which to deliver public health nutrition strategies given their wide reach, and frequent use by children. Online school canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer behaviour strategies that impact on purchasing decisions. The aim of this study is to assess the efficacy of a consumer behaviour intervention implemented in an online school canteen ordering system in reducing the kilojoule, saturated fat, sugar and sodium content of primary student lunch orders. METHODS AND ANALYSIS The study will employ a cluster randomised controlled trial design. Approximately 1040 students (aged 5-12 years) from 10 primary schools in New South Wales, Australia, currently using an online canteen ordering system will be invited to participate. Schools will be randomised in a 1:1 ratio to receive either the intervention (enhanced system) or control (standard online ordering only). The intervention will include evidence-based strategies shown to influence healthy food purchasing (strategies targeting availability, menu labelling, placement and prompting). The primary outcomes of the trial will be the mean content per student online lunch order of (1) energy (kJ), (2) saturated fat (g), (3) sugar (g) and (4) sodium (mg). The impact of the intervention will be determined by between-group assessment of the nutritional content of lunch purchases over a 2-month period postintervention initiation. ETHICS AND DISSEMINATION The study was approved by the Hunter New England Human Research Ethics Committee, University of Newcastle Human Research Ethics Committee and New South Wales Department of Education and School Communities. Study findings will be disseminated widely through peer-reviewed publications and relevant presentations in international conferences and to stakeholders. TRIAL REGISTRATION NUMBER ACTRN12616000499482.
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Affiliation(s)
- Tessa Delaney
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, New South Wales, Australia
| | - Rebecca Wyse
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, New South Wales, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, New South Wales, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, New South Wales, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University,Burwood, Victoria, Australia
| | - Karen Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University,Burwood, Victoria, Australia
| | - Chris Rissel
- NSW Office of Preventive Health, and The University of Sydney, Sydney, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Research Centre for Health Behaviour, The University of Newcastle, New South Wales, Australia
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Wolfenden L, Yoong SL, Williams CM, Grimshaw J, Durrheim DN, Gillham K, Wiggers J. Embedding researchers in health service organizations improves research translation and health service performance: the Australian Hunter New England Population Health example. J Clin Epidemiol 2017; 85:3-11. [PMID: 28341367 DOI: 10.1016/j.jclinepi.2017.03.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 03/07/2017] [Accepted: 03/14/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, New South Wales, 2305, Australia; Hunter New England Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, New South Wales 2287, Australia.
| | - Sze Lin Yoong
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, New South Wales, 2305, Australia; Hunter New England Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, New South Wales 2287, Australia
| | - Christopher M Williams
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, New South Wales, 2305, Australia; Hunter New England Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, New South Wales 2287, Australia
| | - Jeremy Grimshaw
- Ottawa Hospital Research Institute, Ottawa General Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
| | - David N Durrheim
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, New South Wales, 2305, Australia; Hunter New England Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, New South Wales 2287, Australia
| | - Karen Gillham
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, New South Wales, 2305, Australia; Hunter New England Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, New South Wales 2287, Australia
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, New South Wales, 2305, Australia; Hunter New England Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, New South Wales 2287, Australia
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