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Rummo PE, Seet C, Reimold AE, Duffy EW, Prestemon CE, Hall MG, Bragg MA, Taillie LS. Online retail nudges to help parents with lower-income choose healthy beverages for their children: A randomized clinical trial. Pediatr Obes 2024; 19:e13150. [PMID: 38993007 DOI: 10.1111/ijpo.13150] [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: 03/13/2024] [Revised: 05/21/2024] [Accepted: 06/10/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Nudges offer a promising tool to reduce sugary drink intake among children who are most at risk for diet-related disease. OBJECTIVE To examine the impact of online store nudges on purchases of sugary drinks for children in lower-income households. METHODS Caregivers with lower-income were recruited to an online shopping experiment and instructed to spend $10-$30 on three beverages for their child aged 1-5 years. Participants were randomized to navigate an online supermarket in its standard version (n = 1106) or a version with nudges (n = 1135), including a product placement nudge (i.e. placing healthy beverages in prominent positions) and a swap nudge (i.e. offering a swap of water, plain milk and/or 100% fruit juice upon selection of sugary drinks). RESULTS On average, participants purchased 1887 (SD = 2113) and 620 (SD = 1528) calories from sugary drinks per basket in the control and experimental conditions, respectively. Model-based results indicate that those in the experimental condition purchased 1267 (95% CI: 1419, 1114) fewer calories from sugary drinks, and fewer grams of total sugar (β = -253.5 g (95% CI: -286.3, -220.6)) and added sugar (β = -287.8 g (95% CI: -323.1, -252.5)) purchased from sugary drinks. CONCLUSION Nudges may be an effective, acceptable, scalable strategy for leading caregivers in lower-income households to purchase fewer sugary drinks for their children.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Carla Seet
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Alexandria E Reimold
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily W Duffy
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carmen E Prestemon
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marie A Bragg
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Melo Herrera Y, Vadiveloo M, Blau S, Oaks BM, Quashie NT, Tovar A. Feasibility and acceptability of a personalized, pre-filled online grocery cart to improve benefit redemption and diet quality of grocery purchases among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Appetite 2024; 202:107647. [PMID: 39182850 DOI: 10.1016/j.appet.2024.107647] [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: 06/06/2024] [Revised: 08/14/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024]
Abstract
Most participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) do not fully redeem their benefits due to barriers like transportation, confusing product eligibility, and unclear labeling. Online food shopping enables choice architecture to promote benefit redemption and maximize diet quality. We conducted a mixed-methods pilot randomized-controlled trial to assess the feasibility and acceptability of a pre-filled online grocery shopping cart to improve WIC benefit redemption and diet quality of grocery purchases. Rhode Island WIC participants (n = 24, mean age 29.4 ± 1.1 years, 75% Hispanic, 54% had never grocery shopped online) completed a baseline questionnaire and a simulated shopping episode (SSE), buying WIC and non-WIC items. After a week, we randomized participants into the intervention (personalized, modifiable carts pre-filled with 100% of the 2022 proposed WIC packages) or control (selected their items individually) groups before the second SSE. Both groups had WIC labels. We assessed feasibility using process data and percent agreement to feasibility questions, and acceptability via percent agreement to acceptability questions and post-intervention qualitative interviews. We conducted exploratory analyses to examine differences within and between groups at each timepoint for percent WIC benefit redemption and diet quality of grocery purchases, evaluated using the Grocery Purchase Quality Index-2016 (GPQI-2016) scores. Quantitative study measures suggest that the intervention was feasible and that the personalized, modifiable pre-filled cart was acceptable. These findings were supported during qualitative interviews, where participants highlighted time-savings, flexibility, and WIC labels as facilitators of WIC online shopping. Exploratory results showed significant increases in mean percent redemption of most WIC food categories and non-significant moderate increases in most GPQI-2016 scores. These measures are vital for the future adaptation of a full-scale efficacy trial in real-life settings.
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Affiliation(s)
- Yarisbel Melo Herrera
- Department of Nutrition, University of Rhode Island, Kingston, RI, USA; Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
| | - Maya Vadiveloo
- Department of Nutrition, University of Rhode Island, Kingston, RI, USA
| | - Sarah Blau
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Brietta M Oaks
- Department of Nutrition, University of Rhode Island, Kingston, RI, USA
| | - Nekehia T Quashie
- Department of Public Health, University of Rhode Island, Kingston, RI, USA
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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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.
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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
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Trude ACB, Bunzl NB, Rehman ZN, Elbel B, Lau S, Talal LA, Weitzman BC. "I Don't Want an App to Do the Work for Me": A Qualitative Study on the Perception of Online Grocery Shopping From Small Food Retailers. J Acad Nutr Diet 2024; 124:804-822. [PMID: 38103594 DOI: 10.1016/j.jand.2023.12.005] [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: 04/18/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Small food retailers often stock energy-dense convenience foods, and they are ubiquitous in low-income urban settings. With the rise in e-commerce, little is known about the acceptability of online grocery shopping from small food retailers. OBJECTIVE To explore perceptions of the role of small food retailers (bodegas) in food access and the acceptability of online grocery shopping from bodegas among customers and owners in a diverse New York City urban neighborhood with low incomes. DESIGN In-depth interviews were conducted with bodega owners and adult customers between May and July 2022. PARTICIPANTS/SETTING Bodega owners who either had (n = 4) or had not (n = 2) implemented a locally designed online grocery system. Customers (n = 25) were recruited through purposive sampling and were eligible if they purchased at bodegas (>once per month), had low income (household income ≤130% of the federal poverty level or Supplemental Nutrition Assistance Program [SNAP] participants), and owned smartphones. ANALYSES PERFORMED All interviews were transcribed and analyzed in MAXQDA (Verbi Software, Berlin, Germany), using grounded theory. RESULTS To owners and customers, bodegas were seen as good neighbors providing culturally appropriate foods and an informal financial safety net. Their perceptions concerning food cost and availability of healthy foods in bodegas diverged. Although most perceived online grocery from bodegas as a positive community resource, they also believed it was not suited to their own community because of the bodega's proximity to customers' homes and the low digital literacy of some community members. Customers reported social norms of pride in not using online grocery shopping. Owners and customers believed the service would more likely be used if government benefits such as SNAP allowed payment for online orders. Both suggested improved outreach to increase program awareness and uptake. CONCLUSIONS Online grocery shopping from small food retailers may be acceptable in urban communities with low income and was perceived as a community resource. However, important barriers need to be addressed, such as social norms related to pride in not using online grocery services, digital literacy, program awareness, and allowing SNAP payment for online orders from bodegas.
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Bennett R, Driessen C, Zorbas C, Sacks G, Gupta A, Cameron A, Gomez-Donoso C, Peeters A, Backholer K. ' Healthier options tend to get lost in the noise of online' - Australian shoppers' experiences with online grocery platforms. Public Health Nutr 2024; 27:e134. [PMID: 38742445 PMCID: PMC11148825 DOI: 10.1017/s1368980024001046] [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: 11/03/2023] [Revised: 03/30/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE We aimed to understand what influences parents' purchasing behaviours when shopping for groceries online and potential ways to improve the healthiness of online grocery platforms. DESIGN We conducted semi-structured interviews, guided by the Marketing Mix framework. Reflexive thematic analysis was used to analyse data. SETTING Online interviews were conducted with primary grocery shoppers. PARTICIPANTS Parents (n 14) or caregivers (n 2) using online grocery platforms at least every 2 weeks. RESULTS Most participants perceived purchasing healthy food when shopping for groceries online to be more challenging compared to in physical stores. They expressed concerns about the prominence of online marketing for unhealthy food. Participants from lower socio-economic backgrounds often depended on online supermarket catalogues to find price promotions, but healthy options at discounted prices were limited. Across socio-economic groups, fresh items like meat and fruit were preferred to be purchased instore due to concerns about online food quality.Participants believed online grocery platforms should make healthy foods more affordable and supported regulations on supermarket retailers to promote healthy options and limit unhealthy food promotion online. CONCLUSIONS Participants had varied experiences with online grocery shopping, with both positive and negative aspects. Efforts to improve population diets need to include mechanisms to create health-enabling online grocery retail platforms. Government interventions to restrict marketing of unhealthy foods and promote marketing of healthy options on these platforms warrant investigation.
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Affiliation(s)
- Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christine Driessen
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | | | - Clara Gomez-Donoso
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
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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.
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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
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Crespo-Bellido M, Steeves EA, Hill JL, Kersten S, Nitto AM. Vendors' Perceptions and Experiences with WIC Online Shopping Implementation. Curr Dev Nutr 2024; 8:102084. [PMID: 38375071 PMCID: PMC10875264 DOI: 10.1016/j.cdnut.2024.102084] [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: 11/01/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/21/2024] Open
Abstract
Background Online shopping (OS) holds promise for improving the shopping experience for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). However, little is known about vendors' perspectives on implementing OS in the context of WIC. Objectives The present study aimed to understand vendors' experiences, needs, and barriers to WIC OS implementation. Methods We recruited vendors at various stages of WIC OS planning and implementation (n = 16). Semistructured interviews were conducted, transcribed, and coded using subconstructs of the i-PARIHS framework domains (e.g., Characteristics of the Innovation, recipient, context, and facilitation) to assess determinants related to adoption and implementation of WIC OS among vendors. Results Interviewees represented various organizations, including local (n = 5), regional (n = 4), and national (n = 5) entities, along with enablement platforms (n = 2). The interviews yielded themes related to experiences planning and implementing a WIC OS system (n = 7) and perceived needs and barriers (n = 3). Vendors drew on prior experiences with Supplemental Nutrition Assistance Program (SNAP) OS to inform WIC OS projects, stressing the importance of building relationships and collaborating, particularly in technical partnerships, during WIC OS implementation. They also highlighted the value of leveraging existing OS systems to implement WIC OS projects, discussed WIC OS perceived benefits, emphasized the role of educating staff and participants on its usage, and valued WIC OS implementation guidance provided by WIC agencies. Needs and barriers for vendors contemplating WIC OS implementation included the need for evidence of successful implementation of WIC OS projects, understanding current regulatory implications, and appraising existing priorities and financial considerations for adopting and implementing WIC OS. Conclusions WIC OS innovations are integral to modernizing the federal food assistance program. The present study highlights the role of vendor engagement, collaboration, guidance from WIC agencies, and knowledge sharing in ensuring WIC OS success. These insights can inform how WIC State agencies engage vendors to implement WIC OS.
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Affiliation(s)
| | | | - Jennie L Hill
- Gretchen Swanson Center for Nutrition, Omaha, NE, United States
- Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - Sarah Kersten
- Gretchen Swanson Center for Nutrition, Omaha, NE, United States
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Taillie LS, Bercholz M, Prestemon CE, Higgins ICA, Grummon AH, Hall MG, Jaacks LM. Impact of taxes and warning labels on red meat purchases among US consumers: A randomized controlled trial. PLoS Med 2023; 20:e1004284. [PMID: 37721952 PMCID: PMC10545115 DOI: 10.1371/journal.pmed.1004284] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/02/2023] [Accepted: 08/22/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Policies to reduce red meat intake are important for mitigating climate change and improving public health. We tested the impact of taxes and warning labels on red meat purchases in the United States. The main study question was, will taxes and warning labels reduce red meat purchases? METHODS AND FINDINGS We recruited 3,518 US adults to participate in a shopping task in a naturalistic online grocery store from October 18, 2021 to October 28, 2021. Participants were randomized to one of 4 conditions: control (no tax or warning labels, n = 887), warning labels (health and environmental warning labels appeared next to products containing red meat, n = 891), tax (products containing red meat were subject to a 30% price increase, n = 874), or combined warning labels + tax (n = 866). We used fractional probit and Poisson regression models to assess the co-primary outcomes, percent, and count of red meat purchases, and linear regression to assess the secondary outcomes of nutrients purchased. Most participants identified as women, consumed red meat 2 or more times per week, and reported doing all of their household's grocery shopping. The warning, tax, and combined conditions led to lower percent of red meat-containing items purchased, with 39% (95% confidence interval (CI) [38%, 40%]) of control participants' purchases containing red meat, compared to 36% (95% CI [35%, 37%], p = 0.001) of warning participants, 34% (95% CI [33%, 35%], p < 0.001) of tax participants, and 31% (95% CI [30%, 32%], p < 0.001) of combined participants. A similar pattern was observed for count of red meat items. Compared to the control, the combined condition reduced calories purchased (-312.0 kcals, 95% CI [-590.3 kcals, -33.6 kcals], p = 0.027), while the tax (-10.4 g, 95% CI [-18.2 g, -2.5 g], p = 0.01) and combined (-12.8 g, 95% CI [-20.7 g, -4.9 g], p = 0.001) conditions reduced saturated fat purchases; no condition affected sodium purchases. Warning labels decreased the perceived healthfulness and environmental sustainability of red meat, while taxes increased perceived cost. The main limitations were that the study differed in sociodemographic characteristics from the US population, and only about 30% to 40% of the US population shops for groceries online. CONCLUSIONS Warning labels and taxes reduced red meat purchases in a naturalistic online grocery store. Trial Registration: http://www.clinicaltrials.gov/ NCT04716010.
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Affiliation(s)
- Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Maxime Bercholz
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Carmen E. Prestemon
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Isabella C. A. Higgins
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Anna H. Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Marissa G. Hall
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Lindsay M. Jaacks
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Midlothian, United Kingdom
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Potărniche IA, Saroși C, Terebeș RM, Szolga L, Gălătuș R. Classification of Food Additives Using UV Spectroscopy and One-Dimensional Convolutional Neural Network. SENSORS (BASEL, SWITZERLAND) 2023; 23:7517. [PMID: 37687972 PMCID: PMC10490620 DOI: 10.3390/s23177517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
Food additives are utilized in countless food products available for sale. They enhance or obtain a specific flavor, extend the storage time, or obtain a desired texture. This paper presents an automatic classification system for five food additives based on their absorbance in the ultraviolet domain. Solutions with different concentrations were created by dissolving a measured additive mass into distilled water. The analyzed samples were either simple (one additive solution) or mixed (two additive solutions). The substances presented absorbance peaks between 190 nm and 360 nm. Each substance presents a certain number of absorbance peaks at specific wavelengths (e.g., acesulfame potassium presents an absorbance peak at 226 nm, whereas the peak associated with potassium sorbate is at 254 nm). Therefore, each additive has a distinctive spectrum that can be used for classification. The sample classification was performed using deep learning techniques. The samples were associated with numerical labels and divided into three datasets (training, validation, and testing). The best classification results were obtained using CNN (convolutional neural network) models. The classification of the 404 spectra with a CNN model with three convolutional layers obtained a mean testing accuracy of 92.38% ± 1.48%, whereas the mean validation accuracy was 93.43% ± 2.01%.
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Affiliation(s)
- Ioana-Adriana Potărniche
- Basis of Electronics Department, Faculty of Electronics, Telecommunication and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (L.S.); (R.G.)
| | - Codruța Saroși
- Department of Polymer Composites, Institute of Chemistry “Raluca Ripan”, Babes-Bolyai University, 400294 Cluj-Napoca, Romania;
| | - Romulus Mircea Terebeș
- Communications Department, Faculty of Electronics, Telecommunication and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania;
| | - Lorant Szolga
- Basis of Electronics Department, Faculty of Electronics, Telecommunication and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (L.S.); (R.G.)
| | - Ramona Gălătuș
- Basis of Electronics Department, Faculty of Electronics, Telecommunication and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (L.S.); (R.G.)
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Rummo PE, Ali SH, Kranick J, Thorpe LE, Yi SS. Online Grocery Shopping Behaviors and Attitudes Among Asian Americans. J Immigr Minor Health 2023; 25:496-504. [PMID: 36472715 PMCID: PMC9734475 DOI: 10.1007/s10903-022-01433-6] [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] [Accepted: 11/09/2022] [Indexed: 12/13/2022]
Abstract
How online grocery shopping behaviors differ among Asian American (AA) ethnic subgroups and acculturation level is unknown. From June 9-15, 2020, we administered an online survey to a nationally-derived nonprobability sample of 2,895 AA adults, including 1,737 East, 570 South, and 587 Southeast Asian adults, assessing online grocery shopping (yes/no, frequency, reasons). We used logistic regression to compare responses by subgroup and acculturation score, controlling for sociodemographics. Thirty-percent of participants reported shopping online for groceries in a typical month, with a higher percentage among South (45%) versus East Asian adults (23%). Participants with low (vs. high) acculturation scores were more likely to report a lack of special foods (OR = 0.7; 95% CI: 0.5-0.98) and poor food quality (OR = 0.6; 95% CI: 0.4-0.7) as preventing them from shopping online. Online grocery shopping has the capacity to address inequities in health, potentially via culturally-tailored programs designed for less-acculturated AA adults.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, NYU Grossman School of Medicine, 10016, New York, NY, USA.
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
| | - Julie Kranick
- Department of Population Health, NYU Grossman School of Medicine, 10016, New York, NY, USA
| | - Lorna E Thorpe
- Department of Population Health, NYU Grossman School of Medicine, 10016, New York, NY, USA
| | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, 10016, New York, NY, USA
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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.
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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
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Hodges L, Lowery CM, Patel P, McInnis J, Zhang Q. A Systematic Review of Marketing Practices Used in Online Grocery Shopping: Implications for WIC Online Ordering. Nutrients 2023; 15:446. [PMID: 36678317 PMCID: PMC9866762 DOI: 10.3390/nu15020446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/18/2023] Open
Abstract
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) plans to allow participants to redeem their food package benefits online, i.e., online ordering. As grocery shopping online has become more common, companies have developed strategies to market food products to customers using online (or mobile) grocery shopping platforms. There is a significant knowledge gap in how these strategies may influence WIC participants who choose to shop for WIC foods online. This review examines the relevant literature to (1) identify food marketing strategies used in online grocery shopping platforms, (2) understand how these strategies influence consumer behavior and consumer diet, and (3) consider the implications for WIC participants. A total of 1862 references were identified from a systematic database search, of which 83 were included for full-text screening and 18 were included for data extraction and evidence synthesis. The included studies provide policymakers and other stakeholders involved in developing WIC online order processes with valuable information about the factors that shape healthy food choices in the online food retail environment. Findings indicate that some marketing interventions, such as nutrition labeling and food swaps, may encourage healthier food choices in the online environment and could potentially be tailored to reinforce WIC messaging about a healthy diet.
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Affiliation(s)
- Leslie Hodges
- Economic Research Service, U.S. Department of Agriculture, Kansas City, MO 64105, USA
| | - Caitlin M. Lowery
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Priyanka Patel
- School of Community & Environmental Health, Old Dominion University, Norfolk, VA 23529, USA
| | - Joleen McInnis
- University Libraries, Old Dominion University, Norfolk, VA 23529, USA
| | - Qi Zhang
- School of Community & Environmental Health, Old Dominion University, Norfolk, VA 23529, USA
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Geurden B, Cant J, Beckers J. Food Accessibility in the Suburbs of the Metropolitan City of Antwerp (Belgium): A Factor of Concern in Local Public Health and Active and Healthy Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15754. [PMID: 36497829 PMCID: PMC9737850 DOI: 10.3390/ijerph192315754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Population aging and declining birth rates are key demographic trends of the 21st century. While the overall life expectancy and healthy life years increase, the quality of life and functional capacity worsens due to non-communicable diseases strongly related to aging. Therefore, aging citizens are often vulnerable to food insecurity. The aim of this paper is to provide insights into the physical accessibility of fresh food and possible alternatives within the setting of an aging society in Antwerp (Belgium), a metropolitan city at the heart of the EU Reference Site 'Three Rivers Food Delta'. We demonstrate that a large number of the Antwerp suburban areas in which 15 to 25% of current inhabitants are already over 65 years old are confronted with problematic physical accessibility of food due to long walking distances to the nearest food shop. E-commerce has the potential to provide better access to fresh food. This is especially relevant for people with specific needs, such as health-related diets, dysphagia, and/or limited mobility. However, e-commerce introduces new inequalities, as those who would benefit the most from digital accessibility currently use it least. Hence, the organization of fresh food access requires a more thoughtful organization of the 'last mile' and possible alternatives to home delivery. This makes food accessibility an urgent factor of concern in public health and healthy aging in the Antwerp suburban areas.
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Affiliation(s)
- Bart Geurden
- Centre for Research and Innovation of Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium
- Center for Gastrology and Primary Food Care, 3000 Leuven, Belgium
- Reference Site Three Rivers FoodDelta, EIP on AHA Reference Site Collaborative Network (RSCN), 1040 Brussels, Belgium
| | - Jeroen Cant
- Research Group for Urban Development, Faculty of Design Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Joris Beckers
- Department of Transport and Regional Economics, Faculty of Business and Economics, University of Antwerp, 2000 Antwerp, Belgium
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Age-Specific Differences in Online Grocery Shopping Behaviors and Attitudes among Adults with Low Income in the United States in 2021. Nutrients 2022; 14:nu14204427. [PMID: 36297112 PMCID: PMC9609768 DOI: 10.3390/nu14204427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/10/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Online grocery shopping has surged in popularity, but we know little about online grocery shopping behaviors and attitudes of adults with low income, including differences by age. Methods: From October to November 2021, we used a survey research firm to recruit a convenience sample of adults who have ever received Supplemental Nutrition Assistance Program (SNAP) benefits (n = 3526). Participants completed an online survey designed to assess diet and online food shopping behaviors. Using logistic regression, we examined the relationship between participant characteristics, including age, and the likelihood of online grocery shopping, and separately examined variation in the reasons for online grocery shopping by age. Results: About 54% of the participants reported shopping online for groceries in the previous 12 months. Odds of online shopping were higher for those aged 18−33 years (OR = 1.95 (95% CI: 1.52, 2.52; p < 0.001)) and 34−44 years (OR = 1.50 (95% CI: 1.19, 1.90; p < 0.001)) than for those aged ≥65 years. Odds were also higher for those who were food insecure and those with income below USD 20,000, higher educational attainment, and higher fruit and vegetable intake. Low prices were the most popular reason for online grocery shopping (57%). Adults aged 18−33 years old had higher odds of reporting low prices as a motivating factor than older adults (OR = 2.34 (95% CI: 1.78, 3.08; p < 0.001)) and lower odds of reporting being discouraged by lack of social interaction (OR = 0.34 (95% CI: 0.25, 0.45; p < 0.001)). Conclusion: Strategies for making online grocery shopping more affordable for adults with lower income may be promising, especially online produce. For older adults, additional support may be needed to make online shopping a suitable replacement for in-store shopping, such as education on technology and combining it with opportunities for social support.
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