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Traffic-light labels and financial incentives to reduce sugar-sweetened beverage purchases by low-income Latino families: a randomized controlled trial

  • Rebecca L Franckle (a1), Douglas E Levy (a2) (a3), Lorena Macias-Navarro (a4), Eric B Rimm (a1) (a5) (a6) and Anne N Thorndike (a3) (a4)...

Abstract

Objective

The objective of the present study was to test the effectiveness of financial incentives and traffic-light labels to reduce purchases of sugar-sweetened beverages in a community supermarket.

Design

In this randomized controlled trial, after a 2-month baseline period (February–March 2014), in-store traffic-light labels were posted to indicate healthy (green), less healthy (yellow) or unhealthy (red) beverages. During the subsequent five months (April–August 2014), participants in the intervention arm were eligible to earn a $US 25 in-store gift card each month they refrained from purchasing red-labelled beverages.

Setting

Urban supermarket in Chelsea, MA, USA, a low-income Latino community.

Subjects

Participants were customers of this supermarket who had at least one child living at home. A total of 148 customers (n 77 in the intervention group and n 71 in the control group) were included in the final analyses.

Results

Outcomes were monthly in-store purchases tracked using a store loyalty card and self-reported consumption of red-labelled beverages. Compared with control participants, the proportion of intervention participants who purchased any red-labelled beverages decreased by 9 % more per month (P=0·002). More intervention than control participants reduced their consumption of red-labelled beverages (−23 % v. −2 % for consuming ≥1 red beverage/week, P=0·01).

Conclusions

Overall, financial incentives paired with in-store traffic-light labels modestly reduced purchase and consumption of sugar-sweetened beverages by customers of a community supermarket.

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Copyright

Corresponding author

* Corresponding author: Email rnf726@mail.harvard.edu

References

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1. Malik, V, Popkin, B, Bray, G et al. (2010) Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 121, 13561364.
2. Centers for Disease Control and Prevention (2017) Get the facts: sugar-sweetened beverages and consumption. http://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html (accessed June 2017).
3. Harvard, T.H Chan School of Public Health, The Nutrition Source (2015) Sugary drinks. http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/sugary-drinks/ (accessed June 2017).
4. Park, S (2016) Prevalence of sugar-sweetened beverage intake among adults – 23 states and the District of Columbia, 2013. MMWR Morb Mortal Wkly Rep 65, 169174.
5. Miller, G (2017) Trends in beverage consumption among high school students – United States, 2007–2015. MMWR Morb Mortal Wkly Rep 66, 112116.
6. Ogden, CL, Carroll, MD, Fryar, CD et al. (2015) Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief issue 219, 18.
7. Mayer-Davis, EJ, Lawrence, JM, Dabelea, D et al. (2017) Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012. N Engl J Med 376, 14191429.
8. Kit, BK, Fakhouri, TH, Park, S et al. (2013) Trends in sugar-sweetened beverage consumption among youth and adults in the United States: 1999–2010. Am J Clin Nutr 98, 180188.
9. Roberto, CA & Kawachi, I (2014) Use of psychology and behavioral economics to promote healthy eating. Am J Prev Med 47, 832837.
10. Skov, LR, Lourenco, S, Hansen, GL et al. (2013) Choice architecture as a means to change eating behaviour in self‐service settings: a systematic review. Obes Rev 14, 187196.
11. Thorndike, AN, Bright, O, Dimond, M et al. (2017) Choice architecture to promote fruit and vegetable purchases by families participating in the Special Supplemental Program for Women, Infants, and Children (WIC): randomized corner store pilot study. Public Health Nutr 20, 12971305.
12. Thorndike, AN, Riis, J, Sonnenberg, LM et al. (2014) Traffic-light labels and choice architecture: promoting healthy food choices. Am J Prev Med 46, 143149.
13. Ayala, GX, Baquero, B, Laraia, BA et al. (2013) Efficacy of a store-based environmental change intervention compared with a delayed treatment control condition on store customers’ intake of fruits and vegetables. Public Health Nutr 16, 19531960.
14. Ayala, GX, Baquero, B, Pickrel, JL et al. (2015) A store-based intervention to increase fruit and vegetable consumption: the El Valor de Nuestra Salud cluster randomized controlled trial. Contemp Clin Trials 42, 228238.
15. Sanchez-Flack, J, Pickrel, JL, Belch, G et al. (2017) Examination of the relationship between in-store environmental factors and fruit and vegetable purchasing among Hispanics. Int J Environ Res Public Health 14, E1305.
16. Rothman, RL, Housam, R, Weiss, H et al. (2006) Patient understanding of food labels: the role of literacy and numeracy. Am J Prev Med 31, 391398.
17. Thedford, K (2005) Food labels: who is being educated? J Am Diet Assoc 105, 402403.
18. Thorndike, AN, Sonnenberg, L, Riis, J et al. (2012) A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices. Am J Public Health 102, 527533.
19. Levy, DE, Riis, J, Sonnenberg, LM et al. (2012) Food choices of minority and low-income employees: a cafeteria intervention. Am J Prev Med 43, 240248.
20. Afshin, A, Penalvo, JL, Del Gobbo, L et al. (2017) The prospective impact of food pricing on improving dietary consumption: a systematic review and meta-analysis. PLoS One 12, e0172277.
21. Dimitri, C, Oberholtzer, L, Zive, M et al. (2015) Enhancing food security of low-income consumers: an investigation of financial incentives for use at farmers markets. Food Policy 52, 6470.
22. Bartlett, S, Klerman, J, Olsho, L et al. (2014) Evaluation of the Healthy Incentives Pilot (HIP): Final Report. Prepared by Abt Associates for the U.S. Department of Agriculture, Food and Nutrition Service, September 2014. https://fns-prod.azureedge.net/sites/default/files/HIP-Final.pdf (accessed February 2018).
23. Harnack, L, Oakes, M, Elbel, B et al. (2016) Effects of subsidies and prohibitions on nutrition in a food benefit program: a randomized clinical trial. JAMA Intern Med 176, 16101618.
24. Polacsek, M, Moran, A, Thorndike, AN et al. (2017) A supermarket double-dollar incentive program increases purchases of fresh fruits and vegetables among low-income families with children: the Healthy Double Study. J Nutr Educ Behav. Published online: 7 November 2017. doi: 10.1016/j.jneb.2017.09.013.
25. Healthy Food America (2017) Are Sugary Drink Taxes Working? Early Evidence is Promising. http://www.healthyfoodamerica.org/are_sugary_drink_taxes_working_early_evidence_is_promising (accessed February 2018).
26. Volpp, KG, Troxel, AB, Pauly, MV et al. (2009) A randomized, controlled trial of financial incentives for smoking cessation. N Engl J Med 360, 699709.
27. Cahill, K, Hartmann-Boyce, J & Perera, R (2015) Incentives for smoking cessation. Cochrane Database Syst Rev issue 5, CD004307.
28. Higgins, ST, Heil, SH, Dantona, R et al. (2007) Effects of varying the monetary value of voucher-based incentives on abstinence achieved during and following treatment among cocaine-dependent outpatients. Addiction 102, 271281.
29. Massachusetts Department of Public Health (2010) The Status of Childhood Weight in Massachusetts, 2009. Preliminary Results from Body Mass Index Screening in 80 Essential School Health Districts, 2008–2009. http://www.mass.gov/eohhs/docs/dph/com-health/school/status-childhood-obesity.pdf (accessed June 2017).
30. Boston Public Health Commission (2011) Rethink Your Drink Brochure. http://www.bphc.org/whatwedo/healthy-eating-active-living/sugar-smarts/resources-and-materials/Documents/pdfs/rethinkyourdrink-brochure.pdf (accessed June 2017).
31. Hedrick, VE, Savla, J, Comber, DL et al. (2012) Development of a brief questionnaire to assess habitual beverage intake (BEVQ-15): sugar-sweetened beverages and total beverage energy intake. J Acad Nutr Diet 112, 840849.
32. Moore, LV, Pinard, CA & Yaroch, AL (2016) Features in grocery stores that motivate shoppers to buy healthier foods, ConsumerStyles 2014. J Community Health 41, 812817.
33. Glanz, K., Bader, MD & Iyer, S (2012) Retail grocery store marketing strategies and obesity: an integrative review. Am J Prev Med 42, 503512.
34. Chance, Z, Golin, M & Dhar, R (2014) Why choosing healthy foods is hard, and how to help: presenting the 4Ps framework for behavior change. Cust Need Solut 1, 253262.
35. Lin, CT, Lee, JY & Yen, ST (2004) Do dietary intakes affect search for nutrient information on food labels? Soc Sci Med 59, 19551967.
36. Thorndike, AN, Riis, J & Levy, DE (2016) Social norms and financial incentives to promote employees’ healthy food choices: a randomized controlled trial. Prev Med 86, 1218.

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Traffic-light labels and financial incentives to reduce sugar-sweetened beverage purchases by low-income Latino families: a randomized controlled trial

  • Rebecca L Franckle (a1), Douglas E Levy (a2) (a3), Lorena Macias-Navarro (a4), Eric B Rimm (a1) (a5) (a6) and Anne N Thorndike (a3) (a4)...

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