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Vugts A, van den Heuvel E, Havermans RC. Factors affecting public acceptance of healthy lifestyle nudges. Soc Sci Med 2024; 350:116899. [PMID: 38678647 DOI: 10.1016/j.socscimed.2024.116899] [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: 04/14/2023] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
In two online vignette studies, we investigated the effects of healthy lifestyle nudging and pricing interventions in two different contexts: a supermarket (Study 1) and a train station (Study 2). In Study 1 (N = 318) participants were randomly assigned to evaluate one of eight interventions described in a vignette and designed to either encourage healthier food choices or discourage unhealthy food choices in a supermarket setting. Two interventions comprised a small financial incentive to either encourage a healthy food choice or discourage an unhealthy food choice, but the other six interventions were nudges conceived to specifically impact agency, self-constitution or freedom of choice (three different aspects of autonomy). Relative to these nudges, the financial incentive interventions were not found to be less acceptable or more patronising. Overall, the encouragement of healthy food choices was rated as more acceptable and less patronising. The same pattern of results was found in Study 2 (N = 314). We conclude that interventions threatening specific aspects of one's autonomy do not necessarily affect its acceptance. However, the behavioural focus does affect intervention acceptance, that is, interventions focused on encouraging healthy choices are considered more acceptable than interventions that discourage the unhealthy option.
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Affiliation(s)
- Anastasia Vugts
- HAS green academy University of Applied Sciences, 's-Hertogenbosch, the Netherlands; Laboratory of Behavioural Gastronomy, Centre for Healthy Eating and Food Innovation, Maastricht University Campus Venlo, the Netherlands.
| | - Emmy van den Heuvel
- Laboratory of Behavioural Gastronomy, Centre for Healthy Eating and Food Innovation, Maastricht University Campus Venlo, the Netherlands
| | - Remco C Havermans
- Laboratory of Behavioural Gastronomy, Centre for Healthy Eating and Food Innovation, Maastricht University Campus Venlo, the Netherlands
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2
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Weingarten N, Bach L, Roosen J, Hartmann M. Every step you take: Nudging animal welfare product purchases in a virtual supermarket. Appetite 2024; 197:107316. [PMID: 38492582 DOI: 10.1016/j.appet.2024.107316] [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: 07/11/2023] [Revised: 02/06/2024] [Accepted: 03/14/2024] [Indexed: 03/18/2024]
Abstract
Animal welfare (AW) is a growing concern for consumers in Germany; however, not all consumers regularly purchase products that have been produced according to high AW standards. The goal of the present study is to test the effect of a multilayered nudge to increase the availability and improve the visibility of AW products in a 3D online virtual supermarket (VS). The nudge included a shelf with AW products (referred to as AW shelf) which was made visible through banners and footsteps on the floor of the VS. The sample of this pre-registered experiment consisted of n = 374 German consumers who regularly purchase meat, milk, and eggs. The results demonstrated that the multilayered nudge was highly effective: the percentage of AW products purchased in the nudging condition was almost twice as high as in the control group. Furthermore, we investigated variables that mediate (ease of finding AW products in the VS) and moderate (price sensitivity) the effectiveness of the multilayered nudge, but no evidence for an effect was obtained. We conclude that multilayered nudges may be a promising tool to increase consumers' AW product purchases. More research is needed to replicate this finding with a field study in a real supermarket.
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Affiliation(s)
- Nina Weingarten
- University of Bonn, Institute for Food and Resource Economics, Chair of Agricultural and Food Market Research, Germany.
| | - Leonie Bach
- University of Bonn, Institute for Food and Resource Economics, Chair of Agricultural and Food Market Research, Germany
| | - Jutta Roosen
- Technical University of Munich, TUM School of Management, Chair of Marketing and Consumer Research, Germany; Technical University of Munich, HEF World Agricultural Systems Center, Germany
| | - Monika Hartmann
- University of Bonn, Institute for Food and Resource Economics, Chair of Agricultural and Food Market Research, Germany
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3
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van der Vliet N, Stuber JM, Raghoebar S, Roordink E, van der Swaluw K. Nudging plant-based alternatives to meat and dairy in a real-life online supermarket: A randomized controlled trial. Appetite 2024; 196:107278. [PMID: 38373537 DOI: 10.1016/j.appet.2024.107278] [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: 11/16/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
A shift from predominantly animal-based to plant-based consumption can benefit both planetary and public health. Nudging may help to promote such a shift. This study investigated nudge effects on plant-based alternatives to meat and dairy in an online supermarket. We conducted a two-arm, parallel-group, randomized controlled real-life online supermarket trial. Each customer transaction was randomized to a control arm (regular online supermarket) or an intervention arm (addition of placement, hedonic property and dynamic social norm nudges promoting meat and dairy alternatives). Outcomes were the aggregate of meat and dairy alternative purchases (primary outcome), the number of meat purchases, dairy purchases, meat alternative purchases, and dairy alternative purchases (secondary), and retailer revenue (tertiary). Generalized linear mixed models with a Conway-Maxwell Poisson distribution were used to estimate incidence rate ratios (IRRs). Analyzed data included 8488 transactions by participants (n = 4,266 control arm, n = 4,222 intervention arm), out of which 2,411 (66%) were aged above 45 years, 5,660 (67%) were females, and 1,970 (23%) lived in socially disadvantaged neighborhoods. Intervention arm participants purchased 10% (IRR 1.10 (95% CI 0.99-1.23)) more meat and dairy alternatives and 16% (1.16 (0.99-1.36)) more meat alternatives than control arm participants, although these findings are not statistically significant. There was no difference in dairy alternative purchases (1.00 (0.90-1.10)). Intervention arm participants purchased 3% less meats (0.97 (0.93-1.02)) and 2% less dairy products (0.98 (0.95-1.02)) than control participants. Retailer revenue was not affected (0.98 (0.95-1.01)). Online nudging strategies alone did not lead to a statistically significant higher amount of plant-based purchases, but replication of this work is needed with increased study power. Future studies should also consider nudging strategies as part of a broader set of policies to promote plant-based purchases. TRIAL REGISTRATION: Prospectively registered on 14th of May 2022. ISRCTN16569242 (https://doi.org/10.1186/ISRCTN16569242).
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Affiliation(s)
- Nina van der Vliet
- National Institute of Public Health and the Environment (RIVM), Centre for Sustainability, Environment and Health, 3720 BA, Bilthoven, the Netherlands; Tilburg University Graduate School, Tilburg School of Social and Behavioral Sciences, 5000 LE, Tilburg, the Netherlands
| | - Josine M Stuber
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands.
| | - Sanne Raghoebar
- Wageningen University and Research, Consumption and Healthy Lifestyles Group, Education and Learning Sciences Group, 6706 KN, Wageningen, the Netherlands
| | - Eline Roordink
- National Institute of Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, 3720 BA, Bilthoven, the Netherlands
| | - Koen van der Swaluw
- National Institute of Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, 3720 BA, Bilthoven, the Netherlands; Radboud University, Department of Economics and Business Economics, Nijmegen School of Management, 6500 HK, Nijmegen, the Netherlands
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4
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Stuber JM, Mackenbach JD, de Bruijn GJ, Gillebaart M, Hoenink JC, Middel CNH, de Ridder DTD, van der Schouw YT, Smit EG, Velema E, Vos AL, Waterlander WE, Lakerveld J, Beulens JWJ. Real-world nudging, pricing, and mobile physical activity coaching was insufficient to improve lifestyle behaviours and cardiometabolic health: the Supreme Nudge parallel cluster-randomised controlled supermarket trial. BMC Med 2024; 22:52. [PMID: 38303069 PMCID: PMC10835818 DOI: 10.1186/s12916-024-03268-4] [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: 09/26/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Context-specific interventions may contribute to sustained behaviour change and improved health outcomes. We evaluated the real-world effects of supermarket nudging and pricing strategies and mobile physical activity coaching on diet quality, food-purchasing behaviour, walking behaviour, and cardiometabolic risk markers. METHODS This parallel cluster-randomised controlled trial included supermarkets in socially disadvantaged neighbourhoods across the Netherlands with regular shoppers aged 30-80 years. Supermarkets were randomised to receive co-created nudging and pricing strategies promoting healthier purchasing (N = 6) or not (N = 6). Nudges targeted 9% of supermarket products and pricing strategies 3%. Subsequently, participants were individually randomised to a control (step counter app) or intervention arm (step counter and mobile coaching app) to promote walking. The primary outcome was the average change in diet quality (low (0) to high (150)) over all follow-up time points measured with a validated 40-item food frequency questionnaire at baseline and 3, 6, and 12 months. Secondary outcomes included healthier food purchasing (loyalty card-derived), daily step count (step counter app), cardiometabolic risk markers (lipid profile and HbA1c via finger prick, and waist circumference via measuring tape), and supermarket customer satisfaction (questionnaire-based: very unsatisfied (1) to very satisfied (7)), evaluated using linear mixed-models. Healthy supermarket sales (an exploratory outcome) were analysed via controlled interrupted time series analyses. RESULTS Of 361 participants (162 intervention, 199 control), 73% were female, the average age was 58 (SD 11) years, and 42% were highly educated. Compared to the control arm, the intervention arm showed no statistically significant average changes over time in diet quality (β - 1.1 (95% CI - 3.8 to 1.7)), percentage healthy purchasing (β 0.7 ( - 2.7 to 4.0)), step count (β - 124.0 (- 723.1 to 475.1), or any of the cardiometabolic risk markers. Participants in the intervention arm scored 0.3 points (0.1 to 0.5) higher on customer satisfaction on average over time. Supermarket-level sales were unaffected (β - 0.0 (- 0.0 to 0.0)). CONCLUSIONS Co-created nudging and pricing strategies that predominantly targeted healthy products via nudges were unable to increase healthier food purchases and intake nor improve cardiometabolic health. The mobile coaching intervention did not affect step count. Governmental policy measures are needed to ensure more impactful supermarket modifications that promote healthier purchases. TRIAL REGISTRATION Dutch Trial Register ID NL7064, 30 May 2018, https://www.onderzoekmetmensen.nl/en/trial/20990.
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Affiliation(s)
- Josine M Stuber
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
- Amsterdam Public Health, Amsterdam, the Netherlands.
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - Joreintje D Mackenbach
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Gert-Jan de Bruijn
- Department of Communication Science, University of Antwerp, St-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Marleen Gillebaart
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, the Netherlands
| | - Jody C Hoenink
- Centre for Diet and Activity Research, MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Cédric N H Middel
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Denise T D de Ridder
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Utrecht, the Netherlands
| | - Edith G Smit
- Amsterdam School of Communication Research, University of Amsterdam, Nieuwe Achtergracht 166, Amsterdam, the Netherlands
| | - Elizabeth Velema
- Netherlands Nutrition Centre (Voedingscentrum), Bezuidenhoutseweg 105, The Hague, The Netherlands
| | - Anne L Vos
- Amsterdam School of Communication Research, University of Amsterdam, Nieuwe Achtergracht 166, Amsterdam, the Netherlands
| | - Wilma E Waterlander
- Amsterdam Public Health, Amsterdam, the Netherlands
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Joline W J Beulens
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, De Boelelaan 1117, Amsterdam, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Utrecht, the Netherlands
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5
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Djojosoeparto SK, Poelman MP, Eykelenboom M, Beenackers MA, Steenhuis IHM, van Stralen MM, Olthof MR, Renders CM, van Lenthe FJ, Kamphuis CBM. Do financial constraint and perceived stress modify the effects of food tax schemes on food purchases: moderation analyses in a virtual supermarket experiment. Public Health Nutr 2024; 27:e38. [PMID: 38224250 PMCID: PMC10897579 DOI: 10.1017/s1368980024000077] [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: 02/16/2023] [Revised: 12/07/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE To investigate whether financial constraint and perceived stress modify the effects of food-related taxes on the healthiness of food purchases. DESIGN Moderation analyses were conducted with data from a trial where participants were randomly exposed to: a control condition with regular food prices, an sugar-sweetened beverage (SSB) tax condition with a two-tiered levy on the sugar content in SSB (5-8 g/100 ml: €0·21 per l and ≥8 g/100 ml: €0·28 per l) or a nutrient profiling tax condition where products with Nutri-Score D or E were taxed at a 20 percent level. Outcome measures were overall healthiness of food purchases (%), energy content (kcal) and SSB purchases (litres). Effect modification was analysed by adding interaction terms between conditions and self-reported financial constraint or perceived stress in regression models. Outcomes for each combination of condition and level of effect modifier were visualised. SETTING Virtual supermarket. PARTICIPANTS Dutch adults (n 386). RESULTS Financial constraint or perceived stress did not significantly modify the effects of food-related taxes on the outcomes. Descriptive analyses suggest that in the control condition, the overall healthiness of food purchases was lowest, and SSB purchases were highest among those with moderate/high levels of financial constraint. Compared with the control condition, in a nutrient profiling tax condition, the overall healthiness of food purchases was higher and SSB purchases were lower, especially among those with moderate/high levels of financial constraint. Such patterns were not observed for perceived stress. CONCLUSION Further studies with larger samples are recommended to assess whether food-related taxes differentially affect food purchases of subgroups.
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Affiliation(s)
- Sanne K Djojosoeparto
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
- Chair group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, The Netherlands
| | - Maartje P Poelman
- Chair group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, The Netherlands
| | - Michelle Eykelenboom
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mariëlle A Beenackers
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ingrid HM Steenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carlijn BM Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
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Woodall S, Hollis JH. The Difference between PC-Based and Immersive Virtual Reality Food Purchase Environments on Useability, Presence, and Physiological Responses. Foods 2024; 13:264. [PMID: 38254565 PMCID: PMC10814356 DOI: 10.3390/foods13020264] [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: 12/15/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Computer simulations used to study food purchasing behavior can be separated into low immersion virtual environments (LIVE), which use personal computers and standard monitors to display a scene, and high immersion virtual environments (HIVE) which use virtual reality technology such as head-mounted displays to display a scene. These methods may differ in their ability to create feelings of presence or cybersickness that would influence the usefulness of these approaches. In this present study, thirty-one adults experienced a virtual supermarket or fast-food restaurant using a LIVE system or a HIVE system. Feelings of presence and cybersickness were measured using questionnaires or physiological responses (heart rate and electrodermal activity). The participants were also asked to rate their ability to complete the set task. The results of this study indicate that participants reported a higher sense of presence in the HIVE scenes as compared to the LIVE scenes (p < 0.05). The participant's heart rate and electrodermal activity were significantly higher in the HIVE scene treatment when compared to the LIVE scene (p < 0.05). There was no difference in the participant's ability to complete tasks in the different scenes. In addition, feelings of cybersickness were not different between the HIVE and LIVE scenes.
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Affiliation(s)
| | - James H. Hollis
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50312, USA;
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Pandey S, Olsen A, Perez-Cueto FJA, Thomsen M. Nudging Toward Sustainable Food Consumption at University Canteens: A Systematic Review and Meta-Analysis. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:894-904. [PMID: 37930295 DOI: 10.1016/j.jneb.2023.09.006] [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: 09/19/2022] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION This systematic literature review and meta-analysis investigated the effectiveness of the nudging approach toward sustainable food consumption in the university canteen context. METHODS The systematic literature search was carried out in 5 databases, Web of Science, PubMed, Scopus, ProQuest, and the Royal Library, identifying 14 eligible studies and selecting 9 articles containing adequate information for meta-analysis. The nudging strategies were classified using the typology of interventions in the proximal physical microenvironments framework that resulted in 5 different intervention types: availability, position, size, presentation, and information that belonged to either intervention class-altering properties or placement. RESULTS The study identified presentation, availability, and information as the most promising nudge intervention for achieving sustainable food consumption at the university canteen or similar settings. Nudging by altering the properties had a small effect size (d = 0.16), and nudging by altering placement showed a medium effect size (d = 0.21). DISCUSSION Nudging interventions implemented after understanding consumers' current behavior showed positive effectiveness toward sustainable food consumption rather than implementing random nudges. CONCLUSIONS AND IMPLICATIONS It is important that future studies aim to achieve sustainable food consumption by understanding canteen user food preferences and food choice motives before designing a nudging strategy.
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Affiliation(s)
- Sujita Pandey
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Annemarie Olsen
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | | | - Marianne Thomsen
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark.
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8
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Gustafson CR. Evaluating the relative impact of multiple healthy food choice interventions on choice process variables and choices. Appetite 2023; 187:106596. [PMID: 37169259 DOI: 10.1016/j.appet.2023.106596] [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: 03/08/2023] [Revised: 04/26/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
Fiscal tools-taxes and/or subsidies-are increasingly used to address diet-related health problems. However, some studies have found that these tools are markedly more effective if attention is drawn to the tax or subsidy, suggesting that the price change alone may go unnoticed in the complex food environments that consumers face. Interventions that prompt individuals to consider health during choice show promise for promoting healthy food choices in both simple laboratory settings and complex, real-world markets. In this pre-registered study, I examine the impact of dietary fiber health prompts and/or dietary fiber subsidies on the per-serving fiber content of foods chosen, the documented set of products considered, and (self-reported) nutrition information use by participants in an online supermarket setting. Participants were randomized to one of four conditions: 1) control, 2) subsidy, 3) fiber prompt, and 4) fiber prompt + subsidy. Results show that both the prompt and prompt + subsidy conditions significantly increase fiber content of foods chosen (with the latter having a larger effect). While all three interventions influence the probability of using nutrition information during food choice and affect the set of products that respondents consider relative to the control condition, the effects were larger for the prompt and prompt + subsidy conditions. A multiple mediation analysis illustrates that both direct and indirect (through the set of products considered and the use of fiber information during choice) pathways lead to the significant overall increase in fiber content of selected foods.
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Affiliation(s)
- Christopher R Gustafson
- Department of Agricultural Economics, University of Nebraska-Lincoln 314A Filley Hall, Lincoln, NE, 68583, USA.
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9
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Mah CL, Kennedy L, Taylor NGA, Nicholson T, Jago E, MacDonald B. Effect of a relative pricing intervention and active merchandising on snack purchases: interrupted time series analysis of a hospital retailer-led strategy. Int J Behav Nutr Phys Act 2023; 20:56. [PMID: 37143132 PMCID: PMC10158715 DOI: 10.1186/s12966-023-01426-0] [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: 10/14/2022] [Accepted: 02/14/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Pricing policies have been shown to be an effective lever for promoting healthier dietary choices in consumer food environments. It is not yet well understood how pricing can be used to encourage healthier substitute purchases. The aim of the study was to assess the effect of a retailer-led relative pricing intervention on weekly purchases of targeted snack foods and beverages. METHODS This was an ecological analysis in a real-world large tertiary hospital consumer food environment setting in urban Canada, comprised of four retail outlets: two large cafeterias, one smaller cafeteria, and one grab-and-go café. An interrupted time series analysis was designed to evaluate the effect of Snacking Made Simple, a retailer-led relative pricing intervention applied to 10 popular snack foods and beverages (n = 87 weeks, 66 weeks baseline and 21 weeks intervention, April 2018 to December 2019), on weekly purchase differences between healthier and less healthy targeted items, adjusted for weekly sales volume. Five healthier items were price discounted, alongside a price increase for five less healthy items. The intervention was actively merchandised in keeping with behaviour change theory. RESULTS Weekly purchases of targeted snacks became healthier during the intervention period (β = 21.41, p = 0.0024). This followed a baseline period during which weekly purchases of less healthy targeted snacks had outpaced over time those of healthier targeted snacks (β = -11.02, p = 3.68E-14). We estimated that, all else being equal, a hypothetical 9.43 additional weeks of the intervention would be required to transition to net-healthier targeted snack purchases in this environment. The effects of the intervention varied by retail outlet, and the outcome appears driven by specific food items; further, examining merchandising implementation, we posited whether direct versus indirect substitution may have affected purchasing outcomes. CONCLUSIONS Relative pricing may be a promising way to incentivize healthier substitute purchasing in the consumer food environment. Added attention to merchandising strategy as well as value-add factors within food categories and their effects on price salience may be an important factor in effective intervention design.
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Affiliation(s)
- Catherine L Mah
- Faculty of Health, School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2Nd Floor, 2A03, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Laura Kennedy
- Faculty of Health, School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2Nd Floor, 2A03, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Nathan G A Taylor
- Faculty of Health, School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2Nd Floor, 2A03, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Taylor Nicholson
- Nova Scotia Health, Nutrition & Food Services, Room 246, First Floor, Victoria Building, 1276 South Park St, Halifax, NS, B3H 2Y9, Canada
| | - Emily Jago
- Faculty of Health, School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2Nd Floor, 2A03, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Brenda MacDonald
- Nova Scotia Health, Nutrition & Food Services, Room 246, First Floor, Victoria Building, 1276 South Park St, Halifax, NS, B3H 2Y9, Canada
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10
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Gillebaart M, Blom S, De Boer F, De Ridder D. Prompting vegetable purchases in the supermarket by an affordance nudge: Examining effectiveness and appreciation in a set of field experiments. Appetite 2023; 184:106526. [PMID: 36889509 DOI: 10.1016/j.appet.2023.106526] [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: 12/14/2022] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023]
Abstract
The supermarket is a promising location for stimulating healthier food choices by nudging interventions. However, nudging healthy food choices in the supermarket has shown weak effects to date. The present research introduces a new nudge based on the concept of affordances - i.e., an animated character - that invites interaction with healthy food products and examines its effectiveness and appreciation in a supermarket context. We present findings of a series of three studies. In Study 1, evaluations of the new nudge were collected, revealing that the nudge was appreciated. In Studies 2 and 3, field experiments were conducted to test the nudge's effect on vegetable purchases in a real-life supermarket. Study 3 demonstrated that vegetable purchases increased significantly (up to 17%) when the affordance nudge was placed on the vegetable shelves. Furthermore, customers appreciated the nudge and its potential for implementation. Taken together, this set of studies presents compelling findings illustrating the potential of the affordance nudge for increasing healthy choices in the supermarket.
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Affiliation(s)
- Marleen Gillebaart
- Utrecht University, Department of Social, Health and Organizational Psychology, the Netherlands
| | - Stephanie Blom
- Utrecht University, Department of Social, Health and Organizational Psychology, the Netherlands
| | - Femke De Boer
- Utrecht University, Department of Social, Health and Organizational Psychology, the Netherlands
| | - Denise De Ridder
- Utrecht University, Department of Social, Health and Organizational Psychology, the Netherlands.
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Budhathoki M, Campbell D, Belton B, Newton R, Li S, Zhang W, Little D. Factors Influencing Consumption Behaviour towards Aquatic Food among Asian Consumers: A Systematic Scoping Review. Foods 2022; 11:4043. [PMID: 36553785 PMCID: PMC9777948 DOI: 10.3390/foods11244043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/28/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Asia accounts for over 70% of total global aquatic food consumption, but aquatic food consumption behaviours and attitudes among Asian consumers are poorly documented and understood. This paper synthesises literature on factors influencing aquatic food consumption behaviour in Asia and the potential to support transitions toward more sustainable food consumption patterns. We identified 113 studies for inclusion in a scoping review, and identified five clusters of publications: (1) product attributes, availability, and accessibility (24% of publications); (2) willingness to pay for aquatic foods (25%); (3) psychosocial factors (e.g., attitudes and subjective norms) (17%); (4) sociodemographic and lifestyle factors (21%); and (5) miscellaneous factors, including food safety and social status (13%). This study indicates that multiple interacting factors influence aquatic food consumption behaviours among Asian consumers, among which price is central. Knowledge of, and attitudes toward, the perceived quality and safety of aquatic foods were identified as important but were mediated by household characteristics. Sustainable production practices, country of origin, and ecolabels were found to be less influential on consumption behaviour. We found that improving consumers' knowledge and attitudes about the quality and safety of aquatic foods might positively influence aquatic food consumption behaviour. Future multidisciplinary research is required to better understand interactions among the multiple factors that influence Asian consumers' aquatic food consumption behaviour.
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Affiliation(s)
- Mausam Budhathoki
- Institute of Aquaculture, University of Stirling, Stirling FK9 4LA, UK
| | - Danny Campbell
- Division of Economics, School of Management, University of Stirling, Stirling FK9 5AE, UK
| | - Ben Belton
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI 48824, USA
- WorldFish, Jalan Batu Maung, Pulau Pinang 11960, Malaysia
| | - Richard Newton
- Institute of Aquaculture, University of Stirling, Stirling FK9 4LA, UK
| | - Saihong Li
- Faculty of Arts and Humanities, University of Stirling, Stirling FK9 4LA, UK
| | - Wenbo Zhang
- National Demonstration Center for Experimental Fisheries Science Education, Shanghai Ocean University, Shanghai 201308, China
| | - David Little
- Institute of Aquaculture, University of Stirling, Stirling FK9 4LA, UK
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12
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Leeuwis N, van Bommel T, Alimardani M. A framework for application of consumer neuroscience in pro-environmental behavior change interventions. Front Hum Neurosci 2022; 16:886600. [PMID: 36188183 PMCID: PMC9520489 DOI: 10.3389/fnhum.2022.886600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/23/2022] [Indexed: 11/15/2022] Open
Abstract
Most consumers are aware that climate change is a growing problem and admit that action is needed. However, research shows that consumers' behavior often does not conform to their value and orientations. This value-behavior gap is due to contextual factors such as price, product design, and social norms as well as individual factors such as personal and hedonic values, environmental beliefs, and the workload capacity an individual can handle. Because of this conflict of interest, consumers have a hard time identifying the true drivers of their behavior, as they are either unaware of or unwilling to acknowledge the processes at play. Therefore, consumer neuroscience methods might provide a valuable tool to uncover the implicit measurements of pro-environmental behavior (PEB). Several studies have already defined neurophysiological differences between green and non-green individuals; however, a behavior change intervention must be developed to motivate PEB among consumers. Motivating behavior with reward or punishment will most likely get users engaged in climate change action via brain structures related to the reward system, such as the amygdala, nucleus accumbens, and (pre)frontal cortex, where the reward information and subsequent affective responses are encoded. The intensity of the reward experience can be increased when the consumer is consciously considering the action to achieve it. This makes goal-directed behavior the potential aim of behavior change interventions. This article provides an extensive review of the neuroscientific evidence for consumer attitude, behavior, and decision-making processes in the light of sustainability incentives for behavior change interventions. Based on this review, we aim to unite the current theories and provide future research directions to exploit the power of affective conditioning and neuroscience methods for promoting PEB engagement.
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Affiliation(s)
- Nikki Leeuwis
- Department of Cognitive Science and Artificial Intelligence, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
- Unravel Research, Utrecht, Netherlands
| | | | - Maryam Alimardani
- Department of Cognitive Science and Artificial Intelligence, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
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13
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Sauchelli S, Brunstrom JM. Virtual reality exergaming improves affect during physical activity and reduces subsequent food consumption in inactive adults. Appetite 2022; 175:106058. [PMID: 35460807 DOI: 10.1016/j.appet.2022.106058] [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: 10/11/2021] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 11/02/2022]
Abstract
An individual's affective (i.e. emotional) response to exercise may play an important role in post-exercise eating behaviour for some individuals. Taking advantage of advances in fully immersive virtual reality (VR) technology, this study aimed to: a) examine whether VR exergaming can improve the psychological response to exercise in inactive adults, and b) assess the extent to which this improvement reduces post-exercise appetite and eating behaviour. In a cross-over study, 34 adults not meeting the World Health Organisation's physical activity recommendations completed two exercise sessions on a stationary bike; one while engaging in a VR exergame and one without VR. Monitoring enabled heart rate, energy expenditure, and duration across conditions to be closely matched. The Physical Activity Enjoyment Scale, Feeling Scale, Felt Arousal Scale and Borg's Ratings of Perceived Exertion were measured to capture the affective responses to exercise. Appetite and eating behaviour were evaluated using visual-analogue scales, a computerised food preference task, and intake at a post-exercise buffet meal. Cycling in VR elicited greater exercise enjoyment (p < 0.001, η2p = 0.62), pleasure (p < 0.001, η2p = 0.47), and activation (p < 0.001, η2p = 0.55). VR exergaming did not alter perceived physical exertion (p = 0.64), perceived appetite (p = 0.68), and preference for energy dense (p = 0.78) or sweet/savoury foods (p = 0.90) compared to standard exercise. However, it did result in a mean 12% reduction in post-exercise food intake (mean difference: 105.9 kcal; p < 0.01; η2p = 0.20) and a decrease in relative food intake (p < 0.01; η2p = 0.20), although inter-individual differences in response to VR exergaming were observed. The integration of VR in a cycling workout improves the affective experience of physical activity for inactive adults and reduces subsequent food intake. Virtual reality technology shows potential as an adjunct tool to support adults in weight management programmes become more active, especially for those individuals who are prone to eat in excess after physical activity.
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Affiliation(s)
- Sarah Sauchelli
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom.
| | - Jeffrey M Brunstrom
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom; Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, United Kingdom
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14
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Sundermeir SM, Winkler MR, John S, Colón-Ramos U, Kaur R, Hickson A, Dombrowski RD, Hill AB, Bode B, DeAngelo J, Gittelsohn J. A Commentary on the Healthy Community Stores Case Study Project: Implications for Retailers, Policy, and Future Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8824. [PMID: 35886677 PMCID: PMC9324473 DOI: 10.3390/ijerph19148824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022]
Abstract
In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as future directions for researchers and policy-makers based on results from the prior cross-case analyses. We organize these strategies using key concepts from the Retail Food Environment and Customer Interaction Model. Several key strategies for store success are presented including the use of non-traditional business models, focus on specific retail actors such as store champions and multiple vendor relationships, and a stores' role in the broader community context, as well as the striking challenges faced across store locations. Further exploration of these store strategies and how they are implemented is needed, and may inform policies that can support these types of healthy retail sites and sustain their efforts in improving healthy food access in their communities.
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Affiliation(s)
- Samantha M. Sundermeir
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Megan R. Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Sara John
- Center for Science in the Public Interest, Washington, DC 20005, USA; (S.J.); (A.H.)
| | - Uriyoán Colón-Ramos
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA;
| | - Ravneet Kaur
- Department of Family and Community Medicine, University of Illinois College of Medicine, Rockford, IL 61107, USA;
| | - Ashley Hickson
- Center for Science in the Public Interest, Washington, DC 20005, USA; (S.J.); (A.H.)
| | - Rachael D. Dombrowski
- Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA; (R.D.D.); (B.B.)
| | - Alex B. Hill
- Urban Studies and Planning and Detroit Food Map Initiative, Wayne State University, Detroit, MI 48202, USA;
| | - Bree Bode
- Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA; (R.D.D.); (B.B.)
| | - Julia DeAngelo
- Departments of Health Policy Management & Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
| | - Joel Gittelsohn
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
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15
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Ayala GX, Pickrel JL, Baquero B, Sanchez-Flack J, Lin SF, Belch G, Rock CL, Linnan L, Gittelsohn J, Ji M, Elder JP, Mayer J. The El Valor de Nuestra Salud clustered randomized controlled trial store-based intervention to promote fruit and vegetable purchasing and consumption. Int J Behav Nutr Phys Act 2022; 19:19. [PMID: 35177070 PMCID: PMC8851758 DOI: 10.1186/s12966-021-01220-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/25/2021] [Indexed: 12/14/2022] Open
Abstract
Background Modifying the environment to promote healthy foods is a population-based approach for improving diet. This study evaluated the outcome effectiveness of a food store intervention that used structural and social change strategies to promote fruits and vegetables. It was hypothesized that intervention versus control store customers would improve their consumption of fruits and vegetables at 6 months. Trial design Clustered randomized controlled trial Methods Sixteen pair-matched stores were randomized to an intervention or wait-list control condition. With the research team’s support, intervention stores modified the availability, accessibility, and promotion of fruits and vegetables, including augmenting produce displays within the store and building employees’ capacity to place and promote fruits and vegetables throughout the store (Phase 1), followed by the delivery of a customer-directed marketing campaign for 6 months (Phase 2). From months 7 to 12, stores were encouraged to maintain strategies on their own (Phase 3). Customer-reported daily fruit and vegetable consumption (cups/day) were collected by blinded research assistants at three time-points (baseline, 6 months and 12 months post-baseline) from 369 participating customers (an average of 23/store). Secondary outcomes included customer-reported fruit and vegetable purchasing and other behaviors. Results The study retained the 16 stores and most customers at 6 (91%) and 12 (89%) months. Although significant differences were not observed in the overall sample for vegetable consumption, male customers of intervention versus control stores consumed significantly more fruit daily at 6 months [mean (standard deviation) cups at baseline and six months; intervention: 1.6 (1.5) to 1.6 (1.5) vs. control: 1.4 (1.2) to 1.1 (0.8)]. However, this difference was not observed at 12 months, or among females. There was an overall increase in dollars spent at the targeted store in the intervention versus control condition among male versus female customers at 6 months; however, no change was observed in the percent of dollars spent on fruits and vegetables at the targeted store. Frequency of shopping at the targeted store did not modify intervention effects. Conclusions Structural and social change interventions can modify customers’ behavior in the short-term. Future research should consider methods for achieving longer-term changes, and potential generalizability to other products (e.g., energy-dense sweet and savory products). Trial registration NCT01475526 Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01220-w.
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Affiliation(s)
- Guadalupe X Ayala
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA. .,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA.
| | - Julie L Pickrel
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Barbara Baquero
- Health System and Population Health, School of Public Health, University of Washington, Box 35480, Seattle, WA, 98195, USA
| | - Jennifer Sanchez-Flack
- Department of Pediatrics, University of Illinois Cancer Center, Chicago, USA.,Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, WROB 478, Chicago, IL, 60608, USA
| | - Shih-Fan Lin
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - George Belch
- Marketing Department, Fowler College of Business, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Cheryl L Rock
- Department of Family Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive #0901, La Jolla, CA, 92093, USA
| | - Laura Linnan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 359 Rosenau Hall, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599, USA
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD, 21205-2179, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL, 12901, USA
| | - John P Elder
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Joni Mayer
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
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16
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Sundermeir SM, Trujillo A, Mathew D, Harper K, Gunen B, Poirier L, Gittelsohn J. The Impact of a Pricing Manipulation Intervention on Food Sales in a Small Community Grocery Store in Baltimore City. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2039828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Samantha M. Sundermeir
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Antonio Trujillo
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Daniel Mathew
- Department of Economics and Department of International Studies, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kaitlyn Harper
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bengucan Gunen
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, Maryland, USA
| | - Lisa Poirier
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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17
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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: 1] [Impact Index Per Article: 0.5] [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.
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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;
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18
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van der Laan LN, Papies EK, Ly A, Smeets PAM. Examining the neural correlates of goal priming with the NeuroShop, a novel virtual reality fMRI paradigm. Appetite 2021; 170:105901. [PMID: 34968564 DOI: 10.1016/j.appet.2021.105901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/05/2021] [Accepted: 12/23/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Health goal priming has been shown to stimulate healthy food choices by activating an individual's weight-control goal. The present study combined fMRI with a novel virtual reality food choice task to elucidate the underlying neural mechanisms of health goal priming. Previous research has suggested that the ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) play a role in the incorporation of health considerations into the food choice process. Responses may be more representative for those found in real life when assessed in an environment similar to the actual choice environment. Therefore, the first aim of the study was to explore if a novel virtual reality food choice task is sufficiently sensitive to detect basic valuation processes in food choice. The second aim was to examine whether increased activation in the dlPFC drives the effects of health goal priming. METHODS Fifty-six female participants performed an fMRI food choice task embedded in a virtual supermarket environment. They chose between perceived healthy and unhealthy products in a health prime, hedonic prime, and non-food control condition, while activation in brain areas involved in self-control and valuation (vmPFC, dlPFC) was assessed. RESULTS There were no differences in relative preference for perceived healthy products over unhealthy products between the conditions. There were also no main effects of prime condition on brain activation in the vmPFC and dPFC during food choice. Across conditions, activation in the vmPFC correlated with the tastiness of the chosen product during food choice. CONCLUSIONS Although the study does not provide support for health goal priming triggering neural self-control mechanisms, results did show that virtual reality has potential for a more realistic fMRI food choice paradigm.
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Affiliation(s)
- L N van der Laan
- University Medical Center Utrecht. Image Sciences Institute, the Netherlands.
| | - E K Papies
- University of Glasgow, School of Psychology and Neuroscience, UK
| | - A Ly
- University Medical Center Utrecht. Image Sciences Institute, the Netherlands
| | - P A M Smeets
- University Medical Center Utrecht. Image Sciences Institute, the Netherlands
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19
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Jesse M, Jannach D, Gula B. Digital Nudging for Online Food Choices. Front Psychol 2021; 12:729589. [PMID: 34987443 PMCID: PMC8722444 DOI: 10.3389/fpsyg.2021.729589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
When people search for what to cook for the day, they increasingly use online recipe sites to find inspiration. Such recipe sites often show popular recipes to make it easier to find a suitable choice. However, these popular recipes are not always the healthiest options and can promote an unhealthy lifestyle. Our goal is to understand to what extent it is possible to steer the food selection of people through digital nudging. While nudges have been shown to affect humans' behavior regarding food choices in the physical world, there is little research on the impact of nudges on online food choices. Specifically, it is unclear how different nudges impact (i) the behavior of people, (ii) the time they need to make a decision, and (iii) their satisfaction and confidence with their selection. We investigate the effects of highlighting, defaults, social information, and warnings on the decision-making of online users through two consecutive user studies. Our results show that a hybrid nudge, which both involves setting a default and adding social information, significantly increases the likelihood that a nudged item is selected. Moreover, it may help decreasing the required decision time for participants while having no negative effects on the participant's satisfaction and confidence. Overall, our work provides evidence that nudges can be effective in this domain, but also that the type of a digital nudge matters. Therefore, different nudges should be evaluated in practical applications.
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Affiliation(s)
- Mathias Jesse
- Department of AI and Cybersecurity, University of Klagenfurt, Klagenfurt, Austria
- *Correspondence: Mathias Jesse
| | - Dietmar Jannach
- Department of AI and Cybersecurity, University of Klagenfurt, Klagenfurt, Austria
| | - Bartosz Gula
- Department of Psychology, University of Klagenfurt, Klagenfurt, Austria
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20
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van der Molen AEH, Hoenink JC, Mackenbach JD, Waterlander W, Lakerveld J, Beulens JWJ. Are nudging and pricing strategies on food purchasing behaviors equally effective for all? Secondary analyses from the Supreme Nudge virtual supermarket study. Appetite 2021; 167:105655. [PMID: 34416288 DOI: 10.1016/j.appet.2021.105655] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/13/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
Nudging and pricing strategies are effective in promoting healthier purchases. However, whether the effects are equal across individuals with different personal characteristics is unknown. This exploratory study aimed to examine differential effects of nudging and pricing strategies on food purchases across individuals' levels of impulsivity, price sensitivity, decision-making styles, and food choice motives. Data from a virtual supermarket experiment where participants were exposed to five study conditions (control, nudging, pricing, salient pricing, and salient pricing with nudging) was used. Participants completed questionnaires assessing their impulsivity, price sensitivity, decision-making styles, and food choice motives. The outcome was the percentage of healthy food purchases. Effect modification was analyzed by adding interaction terms to the statistical models and post-hoc probing was conducted for statistically significant interaction terms. We used data from 400 Dutch adult participants (61.3% female, median age 30.0 years (IQR 24.0)). The effects of the nudging and pricing conditions on healthy food purchases were not modified by impulsivity, price sensitivity, decision-making styles, and the food choice motives 'health' and 'price'. Only the interactions of the food choice motive 'natural content of foods' x pricing (B = -1.02, 90%CI = -2.04; -0.01), the food choice motive 'weight control' x nudging (B = -2.15, 90%CI = -3.34; -0.95), and 'weight control' x pricing (B = -1.87, 90%CI = -3.11; -0.62) were statistically significant. Post-hoc probing indicated that nudging and/or pricing strategies were more effective in individuals who gave lower priority to these food choice motives. The effects of nudging and pricing strategies on increasing healthy food purchasing behaviors, at least in a virtual environment, do not seem to be influenced by personal characteristics and may therefore be implemented as general health promoting strategies.
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Affiliation(s)
- Annemarijn E H van der Molen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands
| | - Jody C Hoenink
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands.
| | - Joreintje D Mackenbach
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands
| | - Wilma Waterlander
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands
| | - Joline W J Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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21
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Anderson E, Wei R, Liu B, Plummer R, Kelahan H, Tamez M, Marrero A, Bhupathiraju S, Mattei J. Improving Healthy Food Choices in Low-Income Settings in the United States Using Behavioral Economic-Based Adaptations to Choice Architecture. Front Nutr 2021; 8:734991. [PMID: 34692747 PMCID: PMC8526839 DOI: 10.3389/fnut.2021.734991] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/08/2021] [Indexed: 12/27/2022] Open
Abstract
Low diet quality is a significant public health problem in the United States, especially among low-income populations. The food environment influences dietary choices. When applied to eating behavior, behavioral economics (BE) recognizes that decision biases instigated by a food environment saturated with unhealthy foods may lead people to purchase such foods, even when they possess the necessary information and skills to make healthy dietary choices. Choice architecture, a BE concept that involves modifying the appeal or availability of choices to “nudge” people toward a certain choice, retains freedom of choice but makes unhealthy options less convenient or visible. Choice architecture has been demonstrated to influence food choices in various settings, including supermarkets, convenience stores, and food pantries. These modifications are low-cost and feasible to implement, making them a viable strategy to help “nudge” patrons toward healthier choices in food establishments serving low-income populations, including food pantries and retailers accepting the Supplemental Nutrition Assistance Program. This narrative review searched, appraised, and underscored the strengths and limitations of extant research studies that used choice architecture adaptations to influence food choices among low-income populations in the United States. Findings from studies in food pantry settings suggest the potential of BE strategies to improve the healthfulness of food choices and dietary intake in low-income populations. In food retail settings, research suggests that BE strategies increase sales of healthy foods, like fruits and vegetables. We identify new areas of research needed to determine if BE-based modifications in low-income settings have sustained impacts on diet quality.
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Affiliation(s)
- Emma Anderson
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Ruobin Wei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Binkai Liu
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Rachel Plummer
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Heather Kelahan
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Martha Tamez
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Abrania Marrero
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Shilpa Bhupathiraju
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
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Raghoebar S, van Kleef E, de Vet E. How physical cues surrounding foods influence snack consumption: The case of covering foods. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Xu C, Siegrist M, Hartmann C. The application of virtual reality in food consumer behavior research: A systematic review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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24
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Hoenink JC, Waterlander WE, Mackenbach JD, Mhurchu CN, Wilson N, Beulens JWJ, Nghiem N. Impact of taxes on purchases of close substitute foods: analysis of cross-price elasticities using data from a randomized experiment. Nutr J 2021; 20:75. [PMID: 34493309 PMCID: PMC8424883 DOI: 10.1186/s12937-021-00736-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To examine the effects of health-related food taxes on substitution and complementary purchases within food groups, including from unhealthier to healthier alternatives and between brands. METHODS We used data from a virtual supermarket experiment with data from 4,259 shopping events linked to varying price sets. Substitution or complementary effects within six frequently purchased food categories were analyzed. Products' own- and cross-price elasticities were analyzed using Almost Ideal Demand System models. RESULTS Overall, 37.5% of cross-price elasticities were significant (p < 0.05) and included values greater than 0.10. Supplementary and complementary effects were particularly found in the dairy, meats and snacks categories. For example, a 1% increase in the price of high saturated fat dairy was associated with a 0.18% (SE 0.06%) increase in purchases of low saturated fat dairy. For name- and home-brand products, significant substitution effects were found in 50% (n = 3) of cases, but only in one case this was above the 0.10 threshold. CONCLUSIONS/POLICY IMPLICATIONS Given the relatively low own-price elasticities and the limited substitution and complementary effects, relatively high taxes are needed to substantively increase healthy food purchases at the population level. TRIAL REGISTRATION This study included secondary analyses; the original trial was registered in the Australian New Zealand Clinical Trials Registry ACTRN12616000122459 .
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Affiliation(s)
- Jody C Hoenink
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands. .,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Wilma E Waterlander
- Amsterdam UMC, Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands
| | - Joreintje D Mackenbach
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Amsterdam, The Netherlands
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Joline W J Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Nhung Nghiem
- Department of Public Health, University of Otago, Wellington, New Zealand
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25
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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.
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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.)
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26
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Determinants of Food Choice and Perceptions of Supermarket-Based Nudging Interventions among Adults with Low Socioeconomic Position: The SUPREME NUDGE Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116175. [PMID: 34200437 PMCID: PMC8201246 DOI: 10.3390/ijerph18116175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 01/22/2023]
Abstract
Nudging has received ample attention in scientific literature as an environmental strategy to promote healthy diets, and may be effective for reaching populations with low socioeconomic position (SEP). Therefore, the objective of this study was to investigate how the determinants of food choice shape the perceptions regarding supermarket-based nudging strategies among adults with low SEP. We conducted semi-structured interviews among fifteen adults with low SEP using a pre-defined topic list and visual examples of nudges. Interviews were recorded and transcribed verbatim and content analysis was used to analyse the data. The results show that food costs, convenience, healthiness, taste, and habits were frequently mentioned as determinants of food choice. However, the relative importance of these determinants seemed to be context-dependent. Interviewees generally had a positive attitude towards nudges, especially when they were aligned with product preferences, information needs, and beliefs about the food environment. Still, some interviewees also expressed distrust towards nudging strategies, suspecting ulterior motives. We conclude that nudging strategies should target foods which align with product preferences and information needs. However, the suspicion of ulterior motives highlights an important concern which should be considered when implementing supermarket-based nudging strategies.
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27
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Sacks G, Kwon J, Backholer K. Do taxes on unhealthy foods and beverages influence food purchases? Curr Nutr Rep 2021; 10:179-187. [PMID: 33929703 DOI: 10.1007/s13668-021-00358-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW Interest in taxes on unhealthy foods and beverages as a public health tool has increased in recent years. This paper aimed to summarise recent evidence of the impact of taxes on unhealthy foods and beverages on food purchases, and discuss opportunities to advance knowledge and policy impact. RECENT FINDINGS Evaluations of taxes on unhealthy foods and beverages have shown reductions in purchases of targeted unhealthy products and nutrients. Similarly, data from multiple sources demonstrate that as prices of unhealthy foods and beverages increase, purchase volume decreases. However, studies indicate potential for substitution to non-taxed unhealthy foods, which needs to be factored into taxation design. Taxes on unhealthy foods and beverages are a promising strategy to improve population diets. Further research is required to understand food industry responses to tax implementation, as well as the impact of taxes on population and planetary health outcomes.
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Affiliation(s)
- Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
| | - Janelle Kwon
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
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A Standardized Guide to Developing an Online Grocery Store for Testing Nutrition-Related Policies and Interventions in an Online Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094527. [PMID: 33923246 PMCID: PMC8123213 DOI: 10.3390/ijerph18094527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 01/30/2023]
Abstract
Simulated online grocery store platforms are innovative tools for studying nutrition-related policies and point-of-selection/point-of-purchase interventions in online retail settings, yet there is no clear guidance on how to develop these platforms for experimental research. Thus, we created a standardized guide for the development of an online grocery store, including a detailed description of (1) methods for acquiring and cleaning online grocery store data, and (2) how to design a two-dimensional online grocery store experimental platform. We provide guidance on how to address product categorization, product order/sorting and product details, including how to identify outliers and conflicting nutritional information and methods for standardizing prices. We also provide details regarding our process of “tagging” food items that can be leveraged by future studies examining policies and point-of-selection/point-of-purchase interventions targeting red and processed meat and fruits and vegetables. We experienced several challenges, including obtaining accurate and up-to-date product information and images, and accounting for the presence of store-brand products. Regardless, the methodology described herein will enable researchers to examine the effects of a wide array of nutrition-related policies and interventions on food purchasing behaviors in online retail settings, and can be used as a template for reporting procedures in future research.
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29
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Stuber JM, Hoenink JC, Beulens JWJ, Mackenbach JD, Lakerveld J. Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment. Am J Clin Nutr 2021; 114:628-637. [PMID: 33829225 PMCID: PMC8326041 DOI: 10.1093/ajcn/nqab057] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/11/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Nudging and salient pricing are promising strategies to promote healthy food purchases, but it is possible their effects differ across food groups. OBJECTIVE To investigate in which food groups nudging and/or pricing strategies most effectively changed product purchases and resulted in within-food groups substitutions or spillover effects. METHODS In total, 318 participants successfully completed a web-based virtual supermarket experiment in the Netherlands. We conducted a secondary analysis of a mixed randomized experiment consisting of 5 conditions (within subject) and 3 arms (between subject) to investigate the single and combined effects of nudging (e.g., making healthy products salient), taxes (25% price increase), and/or subsidies (25% price decrease) across food groups (fruit and vegetables, grains, dairy, protein products, fats, beverages, snacks, and other foods). Generalized linear mixed models were used to estimate the incidence rate ratios and 95% CIs for changes in the number of products purchased. RESULTS Compared with the control condition, the combination of subsidies on healthy products and taxes on unhealthy products in the nudging and price salience condition was overall the most effective, as the number of healthy purchases from fruit and vegetables increased by 9% [incidence rate ratio (IRR) = 1.09; 95% CI: 1.02, 1.18], grains by 16% (IRR = 1.16; 95% CI: 1.05, 1.28), and dairy by 58% (IRR = 1.58; 95% CI: 1.31, 1.89), whereas the protein and beverage purchases did not significantly change. Regarding unhealthy purchases, grains decreased by 39% (IRR = 0.72; 95% CI: 0.63, 0.82) and dairy by 30% (IRR = 0.77; 95% CI: 0.68, 0.87), whereas beverage and snack purchases did not significantly change. The groups of grains and dairy showed within-food group substitution patterns toward healthier products. Beneficial spillover effects to minimally targeted food groups were seen for unhealthy proteins (IRR = 0.81; 95% CI: 0.73, 0.91). CONCLUSIONS Nudging and salient pricing strategies have a differential effect on purchases of a variety of food groups. The largest effects were found for dairy and grains, which may therefore be the most promising food groups to target in order to achieve healthier purchases. The randomized trial on which the current secondary analyses were based is registered in the Dutch trial registry (NTR7293; www.trialregister.nl).
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Affiliation(s)
| | - Jody C Hoenink
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands,Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands,Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands,Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands,Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
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30
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Hoenink JC, Stuber JM, Lakerveld J, Waterlander W, Beulens JWJ, Mackenbach JD. The effect of on-shelf sugar labeling on beverage sales in the supermarket: a comparative interrupted time series analysis of a natural experiment. Int J Behav Nutr Phys Act 2021; 18:49. [PMID: 33823851 PMCID: PMC8025575 DOI: 10.1186/s12966-021-01114-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 03/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutrition labels show potential in increasing healthy food and beverage purchases, but their effectiveness seems to depend on the type of label, the targeted food category and the setting, and evidence on their impact in real-world settings is limited. The aim of this study was to evaluate the effectiveness of an industry-designed on-shelf sugar label on the sales of beverages with no, low, medium and high sugar content implemented within a real-world supermarket. METHODS In week 17 of 2019, on-shelf sugar labels were implemented by a Dutch supermarket chain. Non-alcoholic beverages were classified using a traffic-light labeling system and included the beverage categories "green" for sugar free (< 1.25 g/250 ml), "blue" for low sugar (1.25-6.24 g/250 ml), "yellow" for medium sugar (6.25-13.5 g/250 ml) and "amber" for high sugar (> 13.5 g/250 ml). Store-level data on beverage sales and revenue from 41 randomly selected supermarkets for 13 weeks pre-implementation and 21 weeks post-implementation were used for analysis. In total, 30 stores implemented the on-shelf sugar labels by week 17, and the 11 stores that had not were used as comparisons. Outcome measures were differences in the number of beverages sold in the four label categories and the total revenue from beverage sales in implementation stores relative to comparison stores. Analyses were conducted using a multiple-group Interrupted Time Series Approach. Results of individual store data were combined using random effect meta-analyses. RESULTS At the end of the intervention period, the changes in sales of beverages with green (B 3.4, 95%CI -0.3; 7.0), blue (B 0.0, 95%CI -0.6; 0.7), yellow (B 1.3, 95%CI -0.9; 3.5), and amber (B 0.9, 95%CI -5.5; 7.3) labels were not significantly different between intervention and comparison stores. The changes in total revenues for beverages at the end of the intervention period were also not significantly different between intervention and comparison stores. CONCLUSION The implementation of an on-shelf sugar labeling system did not significantly decrease unhealthy beverage sales or significantly increase healthier beverage sales. Nutrition labeling initiatives combined with complementary strategies, such as pricing strategies or other healthy food nudging approaches, should be considered to promote healthier beverage purchases.
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Affiliation(s)
- J C Hoenink
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands. .,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - J M Stuber
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - W Waterlander
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - J W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Utrecht, the Netherlands
| | - J D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
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Hoenink JC, Mackenbach JD, van der Laan LN, Lakerveld J, Waterlander W, Beulens JWJ. Recruitment of Participants for a 3D Virtual Supermarket: Cross-sectional Observational Study. JMIR Form Res 2021; 5:e19234. [PMID: 33560230 PMCID: PMC7902190 DOI: 10.2196/19234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/14/2020] [Accepted: 01/17/2021] [Indexed: 12/19/2022] Open
Abstract
Background Virtual supermarkets offer a practical and affordable setting to test the efficacy of different pricing and nudging strategies before they are implemented in the real world. Despite the advantages of using virtual supermarkets for this purpose, conducting studies in online settings is challenging with regard to recruitment and retention of sufficient and suitable participants. Objective To describe cost, time, and retention with regard to participants recruited using various strategies and potential sociodemographic differences between participants recruited via different strategies. Methods This cross-sectional study used data from a randomized controlled trial in which 455 Dutch adults with low and high educational levels were invited to shop 5 times in a 3D virtual supermarket. Participants were recruited via social media and flyers. A log that tracked the costs of and time spent on the different recruitment strategies was kept by the study team. Outcome measures included the cost of recruitment strategies, the time investment by researchers, and recruitment and attrition rates of participants in the study. Results The median age of study completers was 31.0 (IQR 25.0) and 157 out of 346 study completers (45.4%) were highly educated. Out of the 455 included participants, 235 (51.6%) were recruited via social media campaigns, 131 (28.8%) via home-delivered flyers, 38 (8.4%) via flyers directly distributed by the study team, and 46 (10.1%) via word-of-mouth. Of all paid recruitment strategies, social media campaigns were the cheapest and least time-consuming, whereas the distribution of flyers by the study team was the most expensive and time-consuming recruitment strategy. Age, sex, overweight status, employment situation, and number of adults within the household varied by recruitment strategy. Conclusions Using different recruitment strategies resulted in the efficient recruitment of a representative study sample and retention of participants was relatively high. While “word-of-mouth” was the most cost- and time-effective recruitment strategy, using only one type of recruitment strategy could result in a demographically skewed study population.
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Affiliation(s)
- Jody C Hoenink
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Laura Nynke van der Laan
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Wilma Waterlander
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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Nudging Consumers toward Healthier Food Choices: A Field Study on the Effect of Social Norms. SUSTAINABILITY 2021. [DOI: 10.3390/su13041660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Food choices influence the health of individuals, and supermarkets are the place where part of the world population makes their food choices on a daily basis. Different methods to influence food purchasing habits are used, from promotions to food location. However, very few supermarket chains use social norms, the human need to conform to the perceived behavior of the group, to increase healthy food purchase habits. This research seeks to understand how a social norm nudge, a message conveying fruit and vegetable purchasing norms positioned in strategic places, can effectively change food choices. Using data from an intervention in a Portuguese supermarket, the fruit and vegetable purchase quantities of 1636 customers were measured over three months and compared with the corresponding period of the previous year. The results show that the nudge intervention positively affected those whose purchasing habits are categorized as less healthy, while those with healthy habits were slightly negatively affected. Moreover, a follow-up inferential statistical analysis allows us to conclude that applying this intervention at a larger scale would deliver significant financial results for the supermarket chain in which the study took place, by decreasing the costs related to produce perishability while simultaneously improving the health of the consumer and the sustainability of the planet.
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Blom SSAH, Gillebaart M, De Boer F, van der Laan N, De Ridder DTD. Under pressure: Nudging increases healthy food choice in a virtual reality supermarket, irrespective of system 1 reasoning. Appetite 2021; 160:105116. [PMID: 33450297 DOI: 10.1016/j.appet.2021.105116] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/27/2020] [Accepted: 01/09/2021] [Indexed: 02/08/2023]
Abstract
Previous research has shown that nudging can effectively support people's healthy food choices. Yet, to date knowledge about the psychological premises of nudging is limited, highlighting the need for closer scrutiny to determine how and when nudging is most effective. In the current study, we assessed whether the presumed effect of nudging on healthy food choice is enhanced under time pressure, a condition probing alleged system 1 reasoning. Food choice was studied in a realistic virtual reality supermarket where healthier alternatives were nudged by making them more salient. We additionally explored possible differences in decision-making experiences related to nudging or time pressure. The study took place at a science festival where visitors could decide to participate in a study. Participants (n = 99) had to purchase four products, each from a different product category that was provided on a shopping list. In the nudging condition, one healthier option within each product category was nudged by making it more salient. While a main effect of nudging was found, showing in increased healthy food choices, this effect was not further qualified by time pressure, suggesting that the effectiveness of nudging is not enhanced under system 1 conditions. Relatedly, people who were and who were not aware of the nudges showed similar effects of nudging on healthy food choice. Furthermore, no differences in decision-making experiences showed, suggesting that people have similar experiences regarding impulsive and reflective decision-making irrespective of whether they are being nudged or put under time pressure. All in all, our findings are in line with recent viewpoints on the premises of nudges, suggesting that alleged system 1 conditions are not a prerequisite for nudging to be effective.
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Affiliation(s)
- Stephanie S A H Blom
- Department of Social, Health & Organizational Psychology, Utrecht University, the Netherlands.
| | - Marleen Gillebaart
- Department of Social, Health & Organizational Psychology, Utrecht University, the Netherlands
| | - Femke De Boer
- Department of Social, Health & Organizational Psychology, Utrecht University, the Netherlands
| | - Nynke van der Laan
- Department of Communication and Cognition, Tilburg University, the Netherlands
| | - Denise T D De Ridder
- Department of Social, Health & Organizational Psychology, Utrecht University, the Netherlands
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