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Lakerveld J, Mackenbach JD, de Boer F, Brandhorst B, Broerse JEW, de Bruijn GJ, Feunekes G, Gillebaart M, Harbers M, Hoenink J, Klein M, Mensink F, Middel C, de Ridder DTD, Rutters F, Sluijs I, van der Schouw YT, Schuitmaker TJ, Te Velde SJ, Velema E, Waterlander W, Brug J, Beulens JWJ. Improving cardiometabolic health through nudging dietary behaviours and physical activity in low SES adults: design of the Supreme Nudge project. BMC Public Health 2018; 18:899. [PMID: 30029600 PMCID: PMC6054749 DOI: 10.1186/s12889-018-5839-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
Background Initiating and maintaining a healthy lifestyle -including healthy eating and sufficient physical activity- is key for cardiometabolic health. A health-promoting environment can facilitate a healthy lifestyle, and may be especially helpful to reach individuals with a lower socio-economic status (SES). In the Supreme Nudge project, we will study the effects of pricing and nudging strategies in the supermarket – one of the most important point-of-choice settings for food choices – and of a context-specific mobile physical activity promotion app. This paper describes the stepwise and theory-based design of Supreme Nudge, which aims to develop, implement and evaluate environmental changes for a sustained impact on lifestyle behaviours and cardiometabolic health in low SES adults. Methods Supreme Nudge uses a multi-disciplinary and mixed methods approach, integrating participatory action research, qualitative interviews, experimental pilot studies, and a randomized controlled trial in a real-life (supermarket) setting. First, we will identify the needs, characteristics and preferences of the target group as well as of the participating supermarket chain. Second, we will conduct a series of pilot studies to test novel, promising and feasible intervention components. Third, a final selection of intervention components will be implemented in a full-scale randomised controlled supermarket trial. Approximately 1000 low SES adults will be recruited across 8–12 supermarkets and randomised at supermarket level to receive 1) no intervention (control); 2) environmental nudges such as food product placement or promotion; 3) nudges and a tailored physical activity app that provides time- and context specific feedback; 4) pricing interventions, nudges, and the physical activity app. The effects on dietary behaviours and physical activity will be evaluated at 3, 6 and 12 months, and on cardiometabolic health at 6 and 12 months. Finally, we will evaluate the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of the intervention, and we will use insights from System Innovation and Transition Management theories to define the best strategies for implementation and upscaling beyond the study period. Discussion The Supreme Nudge project is likely to generate thorough evidence relevant for policy and practice on the effects of a mixed method and multi-disciplinary intervention targeting dietary behaviours and physical activity. Trial registration The real-life trial has been registered on 30 May 2018, NTR7302.
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Affiliation(s)
- Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands.
| | - Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Femke de Boer
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, the Netherlands
| | - Boris Brandhorst
- University of Amsterdam, Amsterdam School of Communication Research ASCoR, Amsterdam, the Netherlands
| | - Jacqueline E W Broerse
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, the Netherlands
| | - Gert-Jan de Bruijn
- University of Amsterdam, Amsterdam School of Communication Research ASCoR, Amsterdam, the Netherlands
| | - Gerda Feunekes
- Netherlands Nutrition Centre, the Hague, the Netherlands
| | - Marleen Gillebaart
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, the Netherlands
| | - Marjolein Harbers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jody Hoenink
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Michel Klein
- Department of Computer Science, VU University Amsterdam, Amsterdam, the Netherlands
| | | | - Cédric Middel
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, the Netherlands
| | - Denise T D de Ridder
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, the Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tjerk Jan Schuitmaker
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, the Netherlands
| | | | | | - Wilma Waterlander
- Department of Public Health, Amsterdam Public Health Research institute, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes Brug
- University of Amsterdam, Amsterdam School of Communication Research ASCoR, Amsterdam, the Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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