1
|
Anderson Steeves E, Gillespie R, DeWitt E, Barr M, Cox B, Hudson T, Haynes-Maslow L, Trude ACB, Gustafson A. Barriers and Facilitators to Online Grocery Shopping Among Supplemental Nutrition Assistance Program (SNAP) Participants: A Mixed Method Study. Ecol Food Nutr 2024:1-20. [PMID: 39154382 DOI: 10.1080/03670244.2024.2392557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
This mixed methods study explored online grocery shopping perceptions by surveying individuals who do and do not receive SNAP benefits (n = 129) and by conducting interviews with SNAP recipients (n = 26) who have grocery shopped online. T-tests assessed survey findings, codebook thematic analysis was used to identify qualitative themes, and results were interpreted collectively. Survey results found no differences in perceptions of online grocery shopping between SNAP and non-SNAP recipients (p-values = 0.2-1.0) and that 97% of SNAP recipients felt comfortable using SNAP online. Five qualitative themes were identified and provided context to the survey results. The study findings can inform policy actions within SNAP.
Collapse
Affiliation(s)
| | - Rachel Gillespie
- Department of Family and Consumer Sciences Extension, University of Kentucky, Lexington, Kentucky, USA
| | - Emily DeWitt
- Department of Family and Consumer Sciences Extension, University of Kentucky, Lexington, Kentucky, USA
| | - Makenzie Barr
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Brittany Cox
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Travis Hudson
- Department of Nutrition, University of Tennessee, Knoxville, Tennessee, USA
| | - Lindsey Haynes-Maslow
- Department of Health Policy and Management, University of North Carolina, Chapel Hil, North Carolina, USA
| | - Angela C B Trude
- Department of Nutrition and Dietetics, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
2
|
Ferrante MJ, McGovern L, Epstein LH, Hollis-Hansen K, Leone LA, Anzman-Frasca S. Optimal Defaults in Online Grocery Shopping: A Secondary Analysis to Explore Impacts in Multiresident Households and Families. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:332-341. [PMID: 38416095 DOI: 10.1016/j.jneb.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To examine whether household type (eg, families with children) moderated the effects of an optimal defaults grocery intervention and examine intervention effects on grocery purchases to be consumed by the participant vs others in the household. METHODS Participants (n = 65) diagnosed with or at risk for type 2 diabetes were recruited and randomized into an optimal default online grocery intervention or an online or in-person control group. Grocery receipt data were coded into Dietary Approaches to Stop Hypertension nutritional quality scores, and energy, carbohydrate, and sugar content were calculated. Repeated measures analysis of variance examined household types (eg, single vs multi-resident) as moderators of intervention effects. Parallel models explored foods purchased for the participant and foods purchased for other household members separately. RESULTS Household type was not a significant moderator of intervention effects on nutritional quality or other nutrients of interest (P > 0.10). The default intervention significantly increased the nutritional quality of groceries purchased across household types and for other household members besides the participant (P < 0.05). CONCLUSIONS AND IMPLICATIONS Optimal defaults may improve grocery purchases across different household types and extend to others in the household, supporting use across household types.
Collapse
Affiliation(s)
- Mackenzie J Ferrante
- Department of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ
| | - Lily McGovern
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY
| | - Kelseanna Hollis-Hansen
- Peter O'Donnell Jr, School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX
| | - Lucia A Leone
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY; Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY.
| |
Collapse
|
3
|
Bennett R, Keeble M, Zorbas C, Sacks G, Driessen C, Grigsby-Duffy L, Adams J, Burgoine T, Backholer K. The potential influence of the digital food retail environment on health: A systematic scoping review of the literature. Obes Rev 2024; 25:e13671. [PMID: 38104965 DOI: 10.1111/obr.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/01/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The digital food retail environment (defined in this study as a digital platform, app or website where food can be purchased by individuals for personal consumption) is an emerging component of the wider food system. We aimed to systematically search and review the literature to understand the potential influence of the digital food retail environment on population diets and health. METHODS Four databases (across health, business, and marketing) and grey literature were searched using terms relating to "food and beverages," "digital," and "purchasing." Identified studies were included if they examined any aspect of the digital food retail environment where outcomes were examined with a health-related focus and were published before September 2023. All study designs were included (quantitative, qualitative, observational, and experimental). Reviews and conference abstracts were excluded. RESULTS We identified 21,382 studies, of which 57 articles were eligible for inclusion. Of the 57 included studies, 30 studies examined online grocery retail, 22 examined online food delivery platforms, and five examined meal kit subscription services. Of the 30 studies examining online grocery retail, six studies reported that customers believed they purchased fewer unhealthy food and beverages when shopping online, compared with shopping in-store. Nevertheless, customers also reported that their ability to choose healthy foods and beverages was reduced when shopping online due to difficulty in product comparison. Studies that examined online food delivery platforms primarily found that they promoted unhealthy foods and beverages more often than healthy options, through extensive use of marketing practices such as price discounts and images, and that unhealthy food offerings on these platforms dominate. Meal kit subscription services offered mostly healthy meals, with studies suggesting that these types of services may help individuals alleviate some of their "mental load" and stress related to cooking meals for their families. CONCLUSIONS The literature describing the digital food retail environment was found to be diverse, with different aspects having potential to impact health in different ways. Some evidence suggests that online grocery retail and meal kit subscription services may have positive population dietary impacts, whereas online food delivery platforms appear likely to promote unhealthy food purchasing. However, the current evidence base is fragmented, with many knowledge gaps. Further research is required to understand the influence of the digital food retail environment on population diets and how these environments can be designed to support healthy food choices.
Collapse
Affiliation(s)
- Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Matthew Keeble
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Christine Driessen
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Lily Grigsby-Duffy
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Thomas Burgoine
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
4
|
Valenčič E, Beckett E, Collins CE, Koroušić Seljak B, Bucher T. Changing the default order of food items in an online grocery store may nudge healthier food choices. Appetite 2024; 192:107072. [PMID: 37797817 DOI: 10.1016/j.appet.2023.107072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 10/07/2023]
Abstract
Restructuring food environments, such as online grocery stores, has the potential to improve consumer health by encouraging healthier food choices. The aim of this study was to investigate whether repositioning foods within an experimental online grocery store can be used to nudge healthier choices. Specifically, we investigated whether repositioning product categories displayed on the website main page, and repositioning individual products within those categories, will influence selection. Adults residing in Australia (n = 175) were randomised to either intervention (high-fibre foods on top) or comparator condition (high-fibre foods on the bottom). Participants completed a shopping task using the experimental online grocery store, with a budget of up to AU$100 to for one person's weekly groceries. The results of this study show that the total fibre content per 100 kcal per cart (p < .001) and total fibre content per cart (p = .036) was higher in the intervention compared to comparator condition. Moreover, no statistical difference between conditions was found for the total number of fibre-source foods (p = .67), the total energy per cart (p = .17), and the total grocery price per cart (p = .70) indicating no evidence of implications for affordability. Approximately half of the participants (48%) reported that they would like to have the option to sort foods based on a specific nutrient criterion when shopping online. This study specifically showed that presenting higher-fibre products and product categories higher up on the online grocery store can increase the fibre content of customers' purchases. These findings have important implications for consumers, digital platform operators, researchers in health and food domains, and for policy makers.
Collapse
Affiliation(s)
- Eva Valenčič
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia; Jožef Stefan Institute, Computer Systems Department, Ljubljana, 1000, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, 1000, Slovenia.
| | - Emma Beckett
- University of Newcastle, School of Environmental and Life Sciences, College of Engineering, Science and Environment, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia; Department of Science, Nutrition Research Australia, Sydney, NSW, 2000, Australia
| | - Clare E Collins
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia
| | - Barbara Koroušić Seljak
- Jožef Stefan Institute, Computer Systems Department, Ljubljana, 1000, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, 1000, Slovenia
| | - Tamara Bucher
- University of Newcastle, School of Environmental and Life Sciences, College of Engineering, Science and Environment, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia
| |
Collapse
|
5
|
McGrath G. Using a divider nudge in supermarket shopping trolleys to increase fruit and vegetable purchases: A feasibility study using an intervention design. NUTR BULL 2023; 48:513-522. [PMID: 37864781 DOI: 10.1111/nbu.12642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/23/2023]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in 16 Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test the feasibility of covertly modifying shopper purchasing behaviour to purchase more F&Vs using a visual divider nudge message (prompts) covering the entire base of shopping trolleys. Placards provided a visual representation of the recommended proportion of the trolley base that should be allocated to fruits and vegetables (implied social norm). Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the weight (kg), total spending and F&V specific spending (Australian dollars) for intervention versus control trolleys for one weekend day only. We also conducted a short intercept survey that was administered independently from the research study day on non-trial shoppers. Shoppers who selected trolleys with the divider nudge placards (n = 102) purchased equal weight of F&Vs (Intervention: mean = 6.25 kg, SD = 5.60 kg, 95% CI = 5.14 kg, 7.35 kg, vs. Control: mean 6.03 kg, SD = 5.17 kg, 95% CI = 5.01 kg, 7.04 kg, p = 0.768) and spent equal amounts on F&Vs compared to shoppers in the control group (n = 102) (Intervention: mean = $41.46, SD = $36.68, 95% CI = $34.25, $48.66, vs. Control: mean $39.85, SD = $33.30, 95% CI = $33.34, $46.39, p = 0.744). There was no difference in the total spending between groups (Intervention: mean = $135.99, SD = $90.10, 95% CI = $118.29, $153.68, vs. Control: mean $155.68, SD = $96.46, 95% CI = $136.73, $174.63, p = 0.133). The divider nudge placard did not lead to any difference in shoppers' purchases of F&Vs. However, this study demonstrates the feasibility of testing a cheap, simple and easy supermarket nutrition intervention. Larger studies are required to elucidate and confirm these findings over the longer term.
Collapse
Affiliation(s)
- Greg McGrath
- La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
6
|
Hollis-Hansen K, Tan S, Bargnesi S, McGovern L, Drozdowsky J, Epstein LH, Leone LA, Mak E, Masci J, Anzman-Frasca S. Feasibility and implementation of a grocery shopping intervention for adults diagnosed with or at-risk for type 2 diabetes. Public Health Nutr 2023; 26:2118-2129. [PMID: 37496394 PMCID: PMC10564597 DOI: 10.1017/s1368980023001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 05/23/2023] [Accepted: 07/05/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE To examine the feasibility and implementation of an optimal defaults intervention designed to align grocery purchases with a diet recommended for people with or at-risk for type 2 diabetes. DESIGN This was a 5-week pilot randomised trial with three groups: in-person grocery shopping, shopping online and shopping online with 'default' carts. Participants were asked to shop normally in Week One, according to group assignment in Weeks Two-Four (intervention period), and as preferred in Week Five. All groups received diabetes-friendly recipes via email each intervention week. SETTING Participants grocery shopped in person or online. Grocery receipt forms, enrolment information and exit surveys were collected remotely and used to assess feasibility and implementation. PARTICIPANTS Sixty-five adults with or at-risk for type 2 diabetes. RESULTS Sixty-two participants completed the exit survey and fifty-five submitted receipts all 5 weeks. Forty utilised recipes, 95 % of whom indicated recipes were somewhat or very useful. Orange chicken, quesadillas and pork with potato and apples were the most liked recipes. Most Defaults group participants accepted at least some default cart items. Recipes with the highest default acceptance were whole grain pasta and chicken, quesadillas with black beans and chicken with olives. Participants' primary concerns about the intervention were costs associated with online shopping, inability to select preferred foods and some recipes including ingredients household members would not eat. CONCLUSIONS The study had high retention, data were successfully collected remotely and the intervention was acceptable to most participants. Tailoring recipes to household preferences may be beneficial in future studies.
Collapse
Affiliation(s)
- Kelseanna Hollis-Hansen
- Peter O’Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA
- Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Sherey Tan
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Sarah Bargnesi
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Lily McGovern
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Julia Drozdowsky
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, USA
| | - Lucia A Leone
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, USA
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Eunice Mak
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jaclyn Masci
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, USA
| |
Collapse
|
7
|
Rummo PE, Roberto CA, Thorpe LE, Troxel AB, Elbel B. Effect of Financial Incentives and Default Options on Food Choices of Adults With Low Income in Online Retail Settings: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e232371. [PMID: 36897592 PMCID: PMC10789116 DOI: 10.1001/jamanetworkopen.2023.2371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Importance Despite recent growth in online redemption of Supplemental Nutrition Assistance Program (SNAP) benefits, no previous work has tested the impact of economic and behavioral economic strategies on food purchasing behaviors in an online grocery retail setting among adults with low income. Objective To examine the extent to which financial incentives and default shopping cart options influence fruit and vegetable purchases. Design, Setting, and Participants This randomized clinical trial used an experimental online grocery store for adults who currently or have ever received SNAP benefits. From October 7 to December 2, 2021, participants were instructed to shop for a week's worth of groceries for their household, with a budget tailored to household size; no payment was taken. Interventions Random assignment to 1 of 4 conditions: no intervention, 50% discount on eligible fruits and vegetables, prefilled shopping carts with tailored fruit and vegetable items (ie, default options), or a combination of the discount and default options. Main Outcomes and Measures The primary outcome was the percentage of nondiscounted dollars spent on eligible fruit and vegetables per basket. Results Of 2744 participants, mean (SD) age was 46.7 (16.0) years, and 1447 (52.7%) identified as women. A total of 1842 participants (67.1%) reported currently receiving SNAP benefits and 1492 (54.4%) reported shopping online for groceries in the previous 12 months. Participants spent a mean (SD) 20.5% (23.5%) of total dollars on eligible fruits and vegetables. Compared with no intervention, those in the discount condition spent 4.7% (98.3% CI, 1.7%-7.7%) of more total dollars on eligible fruits and vegetables; those in the default condition, 7.8% (98.3% CI, 4.8%-10.7%) more; and those in the combination condition, 13.0% (98.3% CI, 10.0%-16.0%) more (P < .001 for all). There was no difference between the discount and the default conditions (P = .06), but the effect in the combination condition was significantly larger than both discount and default conditions (P < .001). Default shopping cart items were purchased by 679 participants (93.4%) in the default condition and 655 (95.5%) in the combination condition, whereas 297 (45.8%) in the control and 361 (52.9%) in the discount conditions purchased those items (P < .001). No variation was observed by age, sex, or race and ethnicity, and results were similar when those who reported never shopping online for groceries were excluded. Conclusions and Relevance In this randomized clinical trial, financial incentives for fruits and vegetables and default options, especially in combination, led to meaningful increases in online fruit and vegetable purchases among adults with low income. Trial Registration ClinicalTrials.gov Identifier: NCT04766034.
Collapse
Affiliation(s)
- Pasquale E. Rummo
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | | | - Lorna E. Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Andrea B. Troxel
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Brian Elbel
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
- Wagner Graduate School of Public Service, New York University, New York, NY
| |
Collapse
|
8
|
McGrath GM. Using social norm nudges in supermarket shopping trolleys to increase fruit and vegetable purchases. NUTR BULL 2023; 48:115-123. [PMID: 36842136 DOI: 10.1111/nbu.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/02/2023] [Accepted: 01/09/2023] [Indexed: 02/27/2023]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in twenty Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test if shopper purchasing behaviour can be modified to purchase more F&Vs using social norm nudge messages (prompts) placed in shopping trolleys. Placards giving the message that the majority of shoppers purchased F&Vs at each shop were placed in shopping trolleys. Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the quantity (kg), total and F&V spending (Australian dollars) for intervention versus control trolleys. We also conducted a short intercept survey that was administered independently from the research study day. Shoppers who selected trolleys with the social norm nudge placards (n = 109) purchased 1.25 kg more F&Vs (Intervention: mean = 5.45 kg, SD = 4.23 kg, 95% CI 4.65 kg, 6.26 kg vs. Control: mean 4.19 kg, SD = 3.75 kg, 95% CI 3.48 kg, 4.90 kg, p = 0.020, Cohen's d = 0.32) and spent an extra $9.10 more on F&Vs compared to shoppers in the control group (n = 109; Intervention: mean = $36.20, SD = $26.30, 95% CI = $31.24, $41.26 vs. Control: mean $27.10, SD = $24.00, 95% CI = $22.50, $31.67, p = 0.008, Cohen's d = 0.36). The social norm nudge placard shows promise in modifying shoppers' purchases to buy more F&Vs. Larger studies are required to elucidate and confirm these findings over the longer term.
Collapse
|
9
|
Anzman-Frasca S, McGovern L, Ferrante MJ, Drozdowsky J, Epstein LH, Hollis-Hansen K, Lassetter L, Leone LA, Tan S. Effects of a grocery shopping intervention designed to improve diet adherence in diabetes: a randomized trial. Obesity (Silver Spring) 2023; 31:62-73. [PMID: 36444835 DOI: 10.1002/oby.23588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/20/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The goal of this study was to examine the potential of an optimal-defaults intervention to promote grocery purchases corresponding to a diet for diabetes. METHODS In total, 65 adults diagnosed with or at increased risk for type 2 diabetes who grocery shopped at one of two study stores were randomized to one of three groups: Defaults, Online, or Control. All groups received diabetes-friendly recipes. In addition, the Online group was asked to grocery shop online during a 3-week intervention, and the Defaults group was asked to shop online, with their online grocery carts prefilled with food items needed to prepare provided recipes. Participants provided weekly grocery receipt data at baseline, at each week of the 3-week intervention, and at post-intervention. RESULTS Overall, the Defaults group had grocery purchases of a significantly greater nutritional quality versus other groups (F = 16.3, p < 0.001). Between-group comparisons of least-squares means showed consistent effects of the Defaults intervention while intervention components were in place, with a similar pattern for energy and carbohydrate content of grocery purchases. CONCLUSIONS These results build upon emerging evidence that optimal defaults can promote healthier grocery purchases. Continued examination of this approach could promote healthy food acquisition in accordance with individual dietary preferences and needs.
Collapse
Affiliation(s)
- Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
| | - Lily McGovern
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Mackenzie J Ferrante
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Julia Drozdowsky
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
| | - Kelseanna Hollis-Hansen
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Lindsay Lassetter
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Lucia A Leone
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Sherey Tan
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| |
Collapse
|
10
|
Valenčič E, Beckett E, Collins CE, Seljak BK, Bucher T. Digital nudging in online grocery stores: A scoping review on current p ractices and gaps. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
11
|
Gillespie R, DeWitt E, Trude ACB, Haynes-Maslow L, Hudson T, Anderson-Steeves E, Barr M, Gustafson A. Barriers and Facilitators of Online Grocery Services: Perceptions from Rural and Urban Grocery Store Managers. Nutrients 2022; 14:nu14183794. [PMID: 36145165 PMCID: PMC9502010 DOI: 10.3390/nu14183794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Online grocery shopping has expanded rapidly in the U.S., yet little is known about the retailer’s perceptions of online grocery services, which can aid in the expansion of services. Furthermore, many barriers to online grocery utilization persist across geographic areas, especially among Supplemental Nutrition Assistance Program (SNAP)-authorized retailers. This study captured perceived barriers and facilitators of online grocery shopping for managers of SNAP-authorized retailers. Qualitative semi-structured interviews were conducted with managers (n = 23) of grocery stores/supermarkets in urban and rural areas across four different states: TN, KY, NC, and NY. Grocery store managers offering online ordering (n = 15) and managers from brick-and-mortar stores without online services (n = 8) participated in the interviews. Three primary themes emerged among managers offering online ordering: (1) order fulfillment challenges, (2) perceived customer barriers, and (3) perceived customer benefits. Among managers at brick-and-mortar locations without online services, four major themes emerged: (1) thoughts on implementing online shopping, (2) COVID-19 pandemic impacts, (3) competition with other stores, and (4) benefits of maintaining brick-and-mortar shopping. This study provides a deeper understanding of retailers’ experience and perceptions of online grocery services among stores authorized to accept SNAP benefits. This perspective is necessary to inform policies and enhance the evolving virtual food marketplace for SNAP customers.
Collapse
Affiliation(s)
- Rachel Gillespie
- Family and Consumer Sciences Extension, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40506, USA
- Correspondence: ; Tel.: +1-859-257-7793
| | - Emily DeWitt
- Family and Consumer Sciences Extension, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40506, USA
| | - Angela C. B. Trude
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA
| | - Lindsey Haynes-Maslow
- Department of Health Policy & Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Travis Hudson
- Department of Nutrition, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN 37996, USA
| | - Elizabeth Anderson-Steeves
- Department of Nutrition, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN 37996, USA
- Gretchen Swanson Center for Nutrition, Omaha, NE 68154, USA
| | - Makenzie Barr
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40506, USA
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40506, USA
- College of Nursing, University of Kentucky, Lexington, KY 40506, USA
| |
Collapse
|
12
|
Trude ACB, Ali SH, Lowery CM, Vedovato GM, Lloyd-Montgomery JM, Hager ER, Black MM. A click too far from fresh foods: A mixed methods comparison of online and in-store grocery behaviors among low-income households. Appetite 2022; 175:106038. [PMID: 35421540 DOI: 10.1016/j.appet.2022.106038] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/09/2022] [Accepted: 04/03/2022] [Indexed: 11/17/2022]
Abstract
A recent policy in the U.S. authorized monthly benefits from a nutrition assistance program - Supplemental Nutrition Assistance Program (SNAP) - to be used online to increase grocery access and promote healthy eating. This study examined online grocery attitudes and purchasing behaviors among low-income SNAP-eligible households with young children with and without online grocery experience. An explanatory sequential mixed methods design was used, including a survey informed by the theory of planned behavior (TPB) and focus groups conducted between November-March 2021. In the quantitative phase, 310 Maryland residents completed an online survey assessing TPB constructs (attitudes, social norms, perceived control), and food purchase frequency online and in-store. Subsequently, 42 participated in the qualitative phase. Differences in TPB constructs and food purchases were compared between families with and without online grocery experience. Online food selection and fees were a common obstacle to online grocery purchasing. Families who had purchased groceries online (57%) had more positive attitudes and perceived fewer barriers to online shopping than those who had not. Self-reported frequency of buying fresh produce (OR = 0.34, p < 0.001), meat and seafood (OR = 0.29, p < 0.001), and sweets (OR = 0.54, p = 0.005) were lower online than in-store. Families discussed mistrust of online hired shoppers and fewer impulse purchases online as reasons for less frequent purchases of produce and sweets, respectively. Successful scale-up of the U.S. policy must address barriers to healthier purchasing behaviors to effectively promote equitable food access, such as decreasing delivery fees and improving the online food selection.
Collapse
Affiliation(s)
- Angela C B Trude
- University of Maryland School of Medicine, Baltimore, 737 W. Lombard St., Baltimore, MD, 21201, USA; New York University, Steinhardt School of Culture, Education, and Human Development, Department of Nutrition and Food Studies, 411 Lafayette St, 5th Floor, New York, NY, 10003, USA.
| | - Shahmir H Ali
- New York University, School of Global Public Health, 708 Broadway, New York, NY, 10003, USA.
| | - Caitlin M Lowery
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC, 27599, USA.
| | - Gabriela M Vedovato
- Federal University of Sao Paulo, Institute of Health and Society, 136 Silva Jardim, Santos, SP, 11015-020, Brazil.
| | - Joy M Lloyd-Montgomery
- University of Maryland School of Medicine, Baltimore, 737 W. Lombard St., Baltimore, MD, 21201, USA; American Psychiatric Association Foundation, 800 Maine Avenue, S.W., Suite 900, Washington, DC, 20024, USA.
| | - Erin R Hager
- University of Maryland School of Medicine, Baltimore, 737 W. Lombard St., Baltimore, MD, 21201, USA; Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Maureen M Black
- University of Maryland School of Medicine, Baltimore, 737 W. Lombard St., Baltimore, MD, 21201, USA; RTI International, Research Triangle Park, NC, 27709, USA.
| |
Collapse
|
13
|
Fuchs KL, Lian J, Michels L, Mayer S, Toniato E, Tiefenbeck V. Effects of Digital Food Labels on Healthy Food Choices in Online Grocery Shopping. Nutrients 2022; 14:nu14102044. [PMID: 35631185 PMCID: PMC9146588 DOI: 10.3390/nu14102044] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/01/2023] Open
Abstract
In order to induce the shift in consumer behavior necessary for the mitigation of diet-related diseases, front-of-package labels (FoPL) such as the Nutri-Score that support consumers in their efforts to identify nutritionally valuable products during grocery shopping have been found to be effective; however, they remain non-compulsory in most regions. Counter-intuitively, a similar stream of research on digital web-based FoPL does not yet exist, even though such digital labels hold several advantages over physical labels. Digital FoPL can provide scalable and personalized interventions, are easier to implement than physical labels, and are especially timely due to the recent increase in online grocery shopping. The goal of this study was to demonstrate the technical feasibility and intervention potential of novel, scalable, and passively triggered health behavior interventions distributed via easy-to-install web browser extensions designed to support healthy food choices via the inclusion of digital FoPL in online supermarkets. To that end, we developed a Chrome web browser extension for a real online supermarket and evaluated the effect of this digital food label intervention (i.e., display of the Nutri-Score next to visible products) on the nutritional quality of individuals’ weekly grocery shopping in a randomized controlled laboratory trial (N = 135). Compared to the control group, individuals exposed to the intervention chose products with a higher nutritional quality (e.g., 8% higher healthy trolley index (HETI), 3.3% less sugar, 7.5% less saturated fat). In particular, users with low food literacy seemed to benefit from the digital FoPL (e.g., 11% higher HETI, 10.5% less sugar, 5.5% less saturated fat). Furthermore, participants exposed to the food label advocated its introduction more strongly than the control group (p = 0.081). Consumers worldwide could easily install such applications to display digital food labels on their end devices, and would thus not have to wait for stakeholders in the food industry to eventually reach consensus on mandatory food label introduction.
Collapse
Affiliation(s)
- Klaus L. Fuchs
- ETH AI Center, ETH Zurich, 8092 Zurich, Switzerland;
- Correspondence: ; Tel.: +41-78-858-7037
| | - Jie Lian
- Institute of Computer Science (ICS-HSG), University of St. Gallen, 9000 St. Gallen, Switzerland; (J.L.); (S.M.)
| | - Leonard Michels
- Institute of Information Systems, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (L.M.); (V.T.)
| | - Simon Mayer
- Institute of Computer Science (ICS-HSG), University of St. Gallen, 9000 St. Gallen, Switzerland; (J.L.); (S.M.)
| | | | - Verena Tiefenbeck
- Institute of Information Systems, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (L.M.); (V.T.)
| |
Collapse
|
14
|
An empirical study to determine the relationship between food purchasing modes and obesity. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns1.6111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The present world is dealing with very high levels of obesity across various regions. There is a total of 38.9 per cent of the population in the world who are suffering from obesity or overweight. In this study, the main focus is to understand the relationship existing among the food purchasing modes and obesity through the means of empirical evidence. The study would put forward the important aspects that can be associated with this relationship and provide further insight into the situation. A quantitative approach is followed where a total of 250 responses are collected to statistically analyse the objectives in hand. It is found that the majority prefer a mixture of both online and offline options when it comes to purchasing in general or even food products. But in the case of other products, the number of respondents preferring the online mode is higher as compared to the specified case of purchase of food products. It is also found that the majority of the female respondents are normal weight category while the majority of the male respondents are overweight category. Similarly, in the case of food habits followed by the respondents.
Collapse
|
15
|
Moran AJ, Headrick G, Perez C, Greatsinger A, Taillie LS, Zatz L, Bleich SN, Rimm EB, Khandpur N. Food marketing practices of major online grocery retailers in the United States, 2019-2020. J Acad Nutr Diet 2022; 122:2295-2310.e2. [DOI: 10.1016/j.jand.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 03/02/2022] [Accepted: 04/07/2022] [Indexed: 11/30/2022]
|
16
|
De Bauw M, De La Revilla LS, Poppe V, Matthys C, Vranken L. Digital nudges to stimulate healthy and pro-environmental food choices in E-groceries. Appetite 2022; 172:105971. [PMID: 35181380 DOI: 10.1016/j.appet.2022.105971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/02/2022]
Abstract
In response to the detrimental health- and environmental impacts of European consumers' dietary patterns, Nutri-Scores and Eco-Scores have been introduced on packages as guidance for choices. Whereas the scores are promising to improve food choices from a nutritional point of view, the scant available literature suggests very limited effects on the environmental impact of food choices. Therefore, there remains a need to explore ways to bring about improvements in both areas. As a growing share of consumers buys food groceries online, new opportunities to steer food choices are being created. This article explores the potential of several digital functionalities to further stimulate healthier and pro-environmental food choices amongst consumers. These functionalities included product recommendation agents, product scores, a real-time average impact score of the chosen food basket and a personalised social norm. Those were tested in a two-stage randomized controlled trial with 1000 Belgian household food decision makers in a mock-up E-grocery. Indices reflecting the nutritional quality (NQI) and environmental impact (EII) of the selected food baskets were calculated. The results indicate that at first, displaying a combined Nutri- and Eco-Score at product level led to improved NQI's, but not EII's. However, the scores also led to shifting behaviour in EII's when facilitated with recommendation agents. The display of the average impact scores of the selected basket and of social norms did not lead to additional improvements. Hence, a combined Nutri- and Eco-Score labelling system is recommended, but an enabling environment to consider both scores is important to realise a shift towards more healthy and environmentally friendly food choices. Apart from manifesting healthier and environmentally friendly products with a centralised labelling system, improving their accessibility should be considered at least as important for behavioural changes.
Collapse
Affiliation(s)
- Michiel De Bauw
- KU Leuven, Department of Earth and Environmental Sciences, Division of Bio-economics, Leuven, Belgium.
| | - Lucia Segovia De La Revilla
- London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Population Health, Department of Population Health, Belgium
| | | | - Christophe Matthys
- KU Leuven, Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, Leuven, Belgium; University Hospitals Leuven, Department of Endocrinology, Leuven, Belgium
| | - Liesbet Vranken
- KU Leuven, Department of Earth and Environmental Sciences, Division of Bio-economics, Leuven, Belgium
| |
Collapse
|
17
|
Martin NM, Barnett DJ, Poirier L, Sundermeir SM, Reznar MM, Gittelsohn J. Moving Food Assistance into the Digital Age: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1328. [PMID: 35162351 PMCID: PMC8835246 DOI: 10.3390/ijerph19031328] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/15/2022] [Accepted: 01/21/2022] [Indexed: 02/01/2023]
Abstract
One of the most basic needs globally, food assistance refers to the multitude of programs, both governmental and non-governmental, to improve food access and consumption by food-insecure individuals and families. Despite the importance of digital and mobile Health (mHealth) strategies in food insecurity contexts, little is known about their specific use in food assistance programs. Therefore, the purpose of this study was to address that gap by conducting a scoping review of the literature. Keywords were defined within the concepts of food assistance and digital technology. The search included relevant peer-reviewed and grey literature from 2011 to 2021. Excluded articles related to agriculture and non-digital strategies. PRISMA guidelines were followed to perform a partnered, two-round scoping literature review. The final synthesis included 39 studies of which most (84.6%) were from the last five years and United States-based (93.2%). The top three types of articles or studies included text and opinion, qualitative research, and website, application, or model development (17.9%). The top three types of digital tools were websites (56.4%), smartphone applications (20.5%), and chatbots (5.1%). Nineteen digital features were identified as desirable. Most tools included just one or two features. The most popular feature to include was online shopping (n = 14), followed by inventory management, and client tracking. Digital tools for individual food assistance represent an opportunity for equitable and stable access to programs that can enhance or replace in-person services. While this review identified 39 tools, all are in early development and/or implementation stages. Review findings highlight an overall lack of these tools, an absence of user-centered design in their development, and a critical need for research on their effectiveness globally. Further analysis and testing of current digital tool usage and interventions examining the health and food security impacts of such tools should be explored in future studies, including in the context of pandemics, where digital tools allow for help from a distance.
Collapse
Affiliation(s)
- Nina M. Martin
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Daniel J. Barnett
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Lisa Poirier
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Samantha M. Sundermeir
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Melissa M. Reznar
- Department of Interdisciplinary Health Sciences, Oakland University School of Health Sciences, Rochester, MI 48309, USA;
| | - Joel Gittelsohn
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| |
Collapse
|
18
|
Stuber JM, Lakerveld J, Kievitsbosch LW, Mackenbach JD, Beulens JWJ. Nudging customers towards healthier food and beverage purchases in a real-life online supermarket: a multi-arm randomized controlled trial. BMC Med 2022; 20:10. [PMID: 35034635 PMCID: PMC8762859 DOI: 10.1186/s12916-021-02205-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/03/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Nudging is increasingly used to promote healthy food choices in supermarkets. Ordering groceries online is gaining in popularity and nudging seems efficacious there as well, but is never comprehensively tested in real-life. We evaluated the real-life effectiveness of nudging in an online supermarket on healthy food purchases. METHODS We conducted a multi-arm, parallel-group, individually randomized controlled trial in an online supermarket. During 1 month, all customers were randomized to (1) control condition, (2) information nudges, (3) position nudges, and (4) information and position nudges combined. Allocation was concealed and customers were not blinded, but unaware of the intervention. Mean differences between the control condition and the intervention arms in the total percentage of healthy purchases were assessed with a linear mixed model. We tested for effect modification by area-level deprivation. RESULTS Based on sales data from 11,775 shoppers, no overall significant effects were detected. Yet, effects were modified by area-level deprivation (pArm 2 < 0.001). Among shoppers from deprived areas, those allocated to information nudges purchased a 2.4% (95%CI 0.8, 4.0) higher percentage of healthy products compared to controls. No significant differences were observed for position (- 1.3%; 95%CI - 2.8, 0.3) and combined nudges (- 0.1%; 95%CI - 1.7, 1.5). Shoppers from non-deprived areas exposed to information nudges (- 1.6%; 95%CI - 3.2, - 0.1) and the combined nudges (- 2.1%; 95%CI - 3.6, - 0.6), but not position nudges (- 0.9%; 95%CI - 2.4, 0.7), purchased a lower percentage of healthy products. CONCLUSION Information nudges in an online supermarket can increase healthy product purchases, but only for those living in deprived areas. The adverse effects found on purchasing behaviors for those from non-deprived areas call for further research. Further research should also focus on real-life effects of online healthy food nudging as part of a broader nutrition intervention strategy, and on the equitability of the online nudging intervention within populations. TRIAL REGISTRATION Retrospectively registered in the ISRCTN registry at May 21, 2021 ( ISRCTN10491616 ).
Collapse
Affiliation(s)
- Josine M Stuber
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - Loes W Kievitsbosch
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, Netherlands
| |
Collapse
|
19
|
Gustafson A, Gillespie R, DeWitt E, Cox B, Dunaway B, Haynes-Maslow L, Steeves EA, Trude ACB. Online Pilot Grocery Intervention among Rural and Urban Residents Aimed to Improve Purchasing Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:871. [PMID: 35055688 PMCID: PMC8775883 DOI: 10.3390/ijerph19020871] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 02/05/2023]
Abstract
Online grocery shopping has the potential to improve access to food, particularly among low-income households located in urban food deserts and rural communities. The primary aim of this pilot intervention was to test whether a three-armed online grocery trial improved fruit and vegetable (F&V) purchases. Rural and urban adults across seven counties in Kentucky, Maryland, and North Carolina were recruited to participate in an 8-week intervention in fall 2021. A total of 184 adults were enrolled into the following groups: (1) brick-and-mortar "BM" (control participants only received reminders to submit weekly grocery shopping receipts); (2) online-only with no support "O" (participants received weekly reminders to grocery shop online and to submit itemized receipts); and (3) online shopping with intervention nudges "O+I" (participants received nudges three times per week to grocery shop online, meal ideas, recipes, Facebook group support, and weekly reminders to shop online and to submit itemized receipts). On average, reported food spending on F/V by the O+I participants was USD 6.84 more compared to the BM arm. Online shopping with behavioral nudges and nutrition information shows great promise for helping customers in diverse locations to navigate the increasing presence of online grocery shopping platforms and to improve F&V purchases.
Collapse
Affiliation(s)
- Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (B.C.); (B.D.)
| | - Rachel Gillespie
- Department of Family and Consumer Sciences Extension, University of Kentucky, Lexington, KY 40506, USA; (R.G.); (E.D.)
| | - Emily DeWitt
- Department of Family and Consumer Sciences Extension, University of Kentucky, Lexington, KY 40506, USA; (R.G.); (E.D.)
| | - Brittany Cox
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (B.C.); (B.D.)
| | - Brynnan Dunaway
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (B.C.); (B.D.)
| | - Lindsey Haynes-Maslow
- Agricultural & Human Sciences, North Carolina State University, Raleigh, NC 27695, USA;
| | | | - Angela C. B. Trude
- Department of Nutrition and Dietetics, Steinhardt School of Culture, Education, and Human Development, New York University, New York City, NY 10003, USA;
| |
Collapse
|
20
|
Abstract
Context Online grocery services are an emerging component of the food system with the potential to address disparities in access to healthy food. Objective We assessed the barriers and facilitators of equitable access to healthy foods in the online grocery environment, and the psychosocial, purchasing, and dietary behaviors related to its use among low-income, diverse populations. Data Sources Four electronic databases were searched to identify relevant literature; 16 studies were identified. Results Barriers to equitable access to healthy food included cost and limited availability of online grocery services in food deserts and rural areas. The expansion of online grocery services and the ability to use nutrition assistance benefits online were equity-promoting factors. Perceived low control over food selection was a psychosocial factor that discouraged online grocery use, whereas convenience and lower perceived stress were facilitators. Findings were mixed regarding healthfulness of foods purchased online. Although few studies assessed diet, healthy food consumption was associated with online grocery use. Conclusion Researchers should assess the impact of online grocery shopping on low-income families’ food purchases and diet. Systematic Review Registration PROSPERO registration no. CRD: 42021240277
Collapse
Affiliation(s)
- Angela C B Trude
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- A.C.B. Trude, 411 Lafayette St, New York, NY 10003, USA. E-mail:
| | - Caitlin M Lowery
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, New York, USA
| | - Gabriela M Vedovato
- Institute of Health and Society, Federal University of Sao Paulo, Santos, Sao Paulo, Brazil
| |
Collapse
|
21
|
Follett L, Bryant A, Beck D, Rice S. Investigating the short and long-term effects of "nutritional-score" pricing on food pantry selections. Appetite 2021; 168:105692. [PMID: 34517072 DOI: 10.1016/j.appet.2021.105692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/18/2022]
Abstract
Approximately one out of ten households in the U.S. experienced food insecurity in 2019 (U. S. Department of Agriculture, 2020). Food pantries have taken on an important role in helping those with both short term and persistent food insecurity. As pantries are increasingly being arranged to allow clients to choose their own food, the question of how to encourage healthy choices is becoming an important topic for discussion. The Des Moines Area Religious Council (DMARC) implemented a "Nutritional-Score" program on September 1, 2017 as an experiment aimed at answering the above question. This program essentially changes the budgets of food pantry clients to make healthier choices cheaper and less healthy choices more expensive. We perform a Bayesian analysis using a zero-inflated Poisson (ZIP) model to help describe the effects of this program on the frequency with which clients choose less healthy items. We find evidence that the Nutritional-score program had a positive effect on the probability of rejecting less healthy items in the short and long term.
Collapse
Affiliation(s)
- Lendie Follett
- Department of Information Management and Business Analytics, Drake University, 2507 University Ave, Des Moines, IA, 50311, USA.
| | - Andrew Bryant
- Department of Marketing, Drake University, 2507 University Ave, Des Moines, IA, 50311, USA.
| | - Daniel Beck
- Des Moines Area Religious Council, 1435 Mulberry St, Des Moines, IA, 50309, USA
| | - Sarai Rice
- Des Moines Area Religious Council, 1435 Mulberry St, Des Moines, IA, 50309, USA
| |
Collapse
|
22
|
Wyse R, Delaney T, Stacey F, Zoetemeyer R, Lecathelinais C, Lamont H, Ball K, Campbell K, Rissel C, Attia J, Wiggers J, Yoong SL, Oldmeadow C, Sutherland R, Nathan N, Reilly K, Wolfenden L. Effectiveness of a Multistrategy Behavioral Intervention to Increase the Nutritional Quality of Primary School Students' Web-Based Canteen Lunch Orders (Click & Crunch): Cluster Randomized Controlled Trial. J Med Internet Res 2021; 23:e26054. [PMID: 34491207 PMCID: PMC8456336 DOI: 10.2196/26054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/16/2021] [Accepted: 06/07/2021] [Indexed: 11/18/2022] Open
Abstract
Background School food outlets represent a key setting for public health nutrition intervention. The recent proliferation of web-based food ordering systems provides a unique opportunity to support healthy purchasing from schools. Embedding evidence-based choice architecture strategies within these routinely used systems provides the opportunity to impact the purchasing decisions of many users simultaneously and warrants investigation. Objective This study aims to assess the effectiveness of a multistrategy behavioral intervention implemented via a web-based school canteen lunch ordering system in reducing the energy, saturated fat, sugar, and sodium content of primary students’ web-based lunch orders. Methods The study used a parallel-group, cohort, cluster randomized controlled trial design with 2207 students from 17 Australian primary schools. Schools with a web-based canteen lunch ordering system were randomly assigned to receive either a multistrategy behavioral intervention that included choice architecture strategies embedded in the web-based system (n=9 schools) or the standard web-based ordering system only (n=8 control schools). Automatically collected student purchasing data at baseline (term 2, 2018) and 12 months later (term 2, 2019) were used to assess trial outcomes. Primary trial outcomes included the mean energy (kJ), saturated fat (g), sugar (g), and sodium (mg) content of student lunch orders. Secondary outcomes included the proportion of all web-based lunch order items classified as everyday, occasional, and caution (based on the New South Wales Healthy School Canteen Strategy) and canteen revenue. Results From baseline to follow-up, the intervention lunch orders had significantly lower energy content (−69.4 kJ, 95% CI −119.6 to −19.1; P=.01) and saturated fat content (−0.6 g, 95% CI −0.9 to −0.4; P<.001) than the control lunch orders, but they did not have significantly lower sugar or sodium content. There was also a small significant between-group difference in the percentage of energy from saturated fat (−0.9%, 95% CI −1.4% to −0.5%; P<.001) but not in the percentage of energy from sugar (+1.1%, 95% CI 0.2% to 1.9%; P=.02). Relative to control schools, intervention schools had significantly greater odds of having everyday items purchased (odds ratio [OR] 1.7, 95% CI 1.5-2.0; P<.001), corresponding to a 9.8% increase in everyday items, and lower odds of having occasional items purchased (OR 0.7, 95% CI 0.6-0.8; P<.001), corresponding to a 7.7% decrease in occasional items); however, there was no change in the odds of having caution (least healthy) items purchased (OR 0.8, 95% CI 0.7-1.0; P=.05). Furthermore, there was no change in schools’ revenue between groups. Conclusions Given the evidence of small statistically significant improvements in the energy and saturated fat content, acceptability, and wide reach, this intervention has the potential to influence dietary choices at a population level, and further research is warranted to determine its impact when implemented at scale. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618000855224; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375075. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2019-030538
Collapse
Affiliation(s)
- Rebecca Wyse
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Tessa Delaney
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Fiona Stacey
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Rachel Zoetemeyer
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | | | - Hannah Lamont
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Kylie Ball
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Karen Campbell
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Chris Rissel
- School of Public Health, University of Sydney, Sydney, Australia
| | - John Attia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - John Wiggers
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | | | - Rachel Sutherland
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Kathryn Reilly
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| |
Collapse
|
23
|
Coffino JA, Han GT, Evans EW, Luba R, Hormes JM. A Default Option to Improve Nutrition for Adults With Low Income Using a Prefilled Online Grocery Shopping Cart. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:759-769. [PMID: 34509276 DOI: 10.1016/j.jneb.2021.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 06/14/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To determine whether a prefilled online grocery shopping (default) cart improves the nutritional quality of groceries purchased compared with receiving nutrition education (NE). DESIGN Longitudinal study. SETTING Three food pantries in the US. PARTICIPANTS Thirty-eight adults with low income. INTERVENTION Groceries were purchased online for 5 consecutive weeks. After a baseline shopping trip, participants were randomized to receive NE or a nutritionally balanced prefilled online grocery shopping cart (ie, default cart) before shopping (from week 1 [T1] to week 4 [T4]). MAIN OUTCOME MEASURES Diet quality (Healthy Eating Index [HEI-2015] scores), energy, and energy density of each online cart (ie, grocery purchases). ANALYSIS Piecewise linear mixed-effects models. RESULTS From baseline to T1, HEI-2015 scores in the default condition significantly increased (95% confidence interval [CI], 9.79-23.39), whereas total calories (95% CI, -10,942 to -1,663) and energy density (95% CI, -0.70 to -0.45) significantly decreased compared with NE. Improved HEI-2015 scores were maintained through T4. Calories and energy density increased from T1 to T4 in the default condition, but values remained lower (ie, more healthful) than the NE condition. In the NE condition, outcomes did not significantly change during the intervention. CONCLUSIONS AND IMPLICATIONS Providing an online default cart may improve the nutritional quality of grocery purchases. However, future research is warranted to assess whether adding a second nudge later in the intervention or combining the NE and default cart further promotes healthy purchasing behavior.
Collapse
Affiliation(s)
- Jaime A Coffino
- Department of Psychology, University at Albany, State University of New York, Albany, NY; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI; Department of Population Health, New York University School of Medicine, New York, NY.
| | - Gloria T Han
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | - E Whitney Evans
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI
| | - Rachel Luba
- Department of Psychology, University at Albany, State University of New York, Albany, NY
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, Albany, NY
| |
Collapse
|
24
|
Wyse R, Jackson JK, Delaney T, Grady A, Stacey F, Wolfenden L, Barnes C, McLaughlin M, Yoong SL. The Effectiveness of Interventions Delivered Using Digital Food Environments to Encourage Healthy Food Choices: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:2255. [PMID: 34208869 PMCID: PMC8308236 DOI: 10.3390/nu13072255] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/22/2021] [Accepted: 06/27/2021] [Indexed: 12/20/2022] Open
Abstract
Digital food environments are now commonplace across many food service and retail settings, influencing how the population orders and accesses foods. As such, digital food environments represent a novel platform to deliver strategies to improve public health nutrition. The purpose of this review was to explore the impact of dietary interventions embedded within online food ordering systems, on user selection and purchase of healthier foods and beverages. A systematic search of eight electronic databases and grey literature sources was conducted up to October 2020. Eligible studies were randomized controlled trials and controlled trials, designed to encourage the selection and purchase of healthier products and/or discourage the selection and purchase of less-healthy products using strategies delivered via real-world online food ordering systems. A total of 9441 articles underwent title and abstract screening, 140 full-text articles were assessed for eligibility, and 11 articles were included in the review. Meta-analysis of seven studies indicated that interventions delivered via online food ordering systems are effective in reducing the energy content of online food purchases (standardized mean difference (SMD): -0.34, p = 0.01). Meta-analyses including three studies each suggest that these interventions may also be effective in reducing the fat (SMD: -0.83, p = 0.04), saturated fat (SMD: -0.7, p = 0.008) and sodium content (SMD: -0.43, p = 0.01) of online food purchases. Given the ongoing growth in the use of online food ordering systems, future research to determine how we can best utilize these systems to support public health nutrition is warranted.
Collapse
Affiliation(s)
- Rebecca Wyse
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Jacklyn Kay Jackson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
| | - Tessa Delaney
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Alice Grady
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Fiona Stacey
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Matthew McLaughlin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (J.K.J.); (T.D.); (A.G.); (F.S.); (L.W.); (C.B.); (M.M.); (S.L.Y.)
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| |
Collapse
|
25
|
Gillespie R, DeWitt E, Norman-Burgdolf H, Dunnaway B, Gustafson A. Community-Based Efforts Aim to Improve the Food Environment within a Highly Obese Rural Appalachian County. Nutrients 2021; 13:nu13072200. [PMID: 34206825 PMCID: PMC8308232 DOI: 10.3390/nu13072200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 12/22/2022] Open
Abstract
Rural communities in Appalachia are displaying increased obesity prevalence, yet traditional interventions have not provided a broad enough impact to improve dietary consumption patterns. Therefore, expanding efforts that address the food environment and incorporate behavioral nudges through community-developed marketing strategies may be a viable mechanism to improve food and beverage choices within this unique population. This study installed shelf-wobblers across n = 5 gas stations in one rural Appalachian county in Kentucky. Smart Snacks were identified from store inventory lists utilizing the CDC Food Service Guideline for Federal Facilities calculator and were categorized into high-protein snacks, low-fat carbohydrate snacks, meal replacement snacks, and no-calorie beverages. NEMS-CS audits were conducted, and monthly sales data was collected at baseline and for six months thereafter for each store location. A difference-in-difference model was used, adjusting for total sales or total mean sales for each Smart Snack model to assess the percentage change within and between stores. Overall, percent change in mean sales and total sales across all stores resulted in a percentage increase of sales of Smart Snack items following wobbler installment. This study provides unique insight into how a community-driven approach to marketing can influence the sale of healthier food and beverage items.
Collapse
Affiliation(s)
- Rachel Gillespie
- Family Consumer Sciences Extension, University of Kentucky, Lexington, KY 40506, USA;
- Correspondence: ; Tel.: +1-859-257-7793
| | - Emily DeWitt
- Family Consumer Sciences Extension, University of Kentucky, Lexington, KY 40506, USA;
| | - Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (H.N.-B.); (B.D.); (A.G.)
| | - Brynnan Dunnaway
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (H.N.-B.); (B.D.); (A.G.)
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (H.N.-B.); (B.D.); (A.G.)
| |
Collapse
|
26
|
Valluri S, Mason SM, Peterson HH, Appelhans B, French SA, Harnack LJ. Associations between shopper impulsivity and cyclical food purchasing: Results from a prospective trial of low-income households receiving monthly benefits. Appetite 2021; 163:105238. [PMID: 33811946 DOI: 10.1016/j.appet.2021.105238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/13/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
Supplemental Nutrition Assistance Program (SNAP) benefits are rapidly depleted after distribution. This phenomenon, known as the benefit cycle, is associated with poor nutrition and health outcomes. Proposed interventions targeting the benefit cycle often focus on impulsive decision-making. However, it remains unclear whether shopper impulsivity is associated with food purchasing behavior. Using data from a prospective trial, we evaluate whether shopper impulsivity is associated with food purchasing behavior before and after households receive nutrition assistance. In this study, 249 low-income households in the Minneapolis-St. Paul, Minnesota, metropolitan area received monthly benefits for three months. Overall impulsivity and impulsivity subtraits of the primary shopper was assessed using the Barratt Impulsiveness Scale-11. Both total food expenditures and expenditures for two specific categories (fruits and vegetables, and foods high in added sugar) were evaluated. Generalized estimating equations were used to model household expenditures as a function of week since benefit distribution, impulsivity, and their interaction. Results showed that during the benefit period, food expenditures were cyclical and patterned by impulsivity. Shoppers with greater overall impulsivity spent $40.62 more in week 1 (p < 0.001). While more impulsive shoppers spent more on foods high in added sugar throughout the month (p < 0.05 for all weeks), no patterns were observed for fruits and vegetables. These findings suggest that greater impulsivity exacerbates cyclical food purchasing behavior. The impact of shopper impulsivity is especially notable for expenditures on foods high in added sugar. SNAP educational interventions to mitigate the benefit cycle may be strengthened by focusing on more impulsive shoppers and on strategies to reduce impulsive purchases of foods high in added sugar.
Collapse
Affiliation(s)
- Sruthi Valluri
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Susan M Mason
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Hikaru Hanawa Peterson
- Department of Applied Economics, College of Food, Agricultural and Natural Resource Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Brad Appelhans
- Department of Preventive Medicine, Rush Medical College, USA
| | - Simone A French
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Lisa J Harnack
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
27
|
Harnack L, Redden J, French S, Sherwood NE, Rivera G, Valluri S, Tahir M. Designing online grocery stores to support healthy eating for weight loss. Public Health Nutr 2021; 25:1-11. [PMID: 33634775 PMCID: PMC8387504 DOI: 10.1017/s1368980021000896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/01/2021] [Accepted: 02/23/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The current study aimed to identify features to include in online grocery stores to support healthful food purchasing by those striving to lose weight. DESIGN A Value Proposition Design approach was used to gain shopper insights, devise potential online grocery store features and obtain feedback on these features. SETTING Telephone interviews were conducted to gain insight into shoppers' needs and perceptions. Results were used by the research team to identify potential online grocery shopping features that may support healthful purchase decisions, and interviews were conducted with a different sample of shoppers to gather feedback on features. PARTICIPANTS Insight (n 25) and feedback (n 25) interviews were conducted with convenience samples of adults trying to lose weight. RESULTS Participants were primarily female, white, college educated and with obesity or overweight. Online grocery features devised by the research team based on findings from the insight interviews included (1) shopping cart nutrition rating tool; (2) healthy meal planning tool; (3) interactive healthy eating inspiration aisle and (4) healthy shopping preference settings option. Findings from the feedback interviews indicated that the healthy meal planning tool, healthy shopping preference settings option and shopping cart nutrition rating tool features were positively rated by most participants. CONCLUSIONS There are multiple features grocers should consider including in their online stores to attract and support customers striving to eat healthy for weight loss.
Collapse
Affiliation(s)
- Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Joseph Redden
- Carlson School of Management, University of Minnesota, Minneapolis, MN, USA
| | - Simone French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Gabrielle Rivera
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Sruthi Valluri
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Muna Tahir
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| |
Collapse
|