Nudging Nutrition With Monetary Incentives Environmental Cues

Study Overview
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Brief Summary
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The investigators hypothesize that monetary incentives and messaging, such as making nutritious foods relatively less expensive than less nutritious foods and framing the price difference in a positive or negative way, will influence purchasing behavior of households.

Detailed Description
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In this study, 239 loyalty card shoppers were recruited at Hannaford grocery stores to participate in a study in which a 10% price difference between nutritious and less nutritious foods was introduced. and then framed as a subsidy, tax, or a combination of a tax and subsidy. To determine whether or not the framing of the price difference influenced purchasing behavior, the difference was framed as a subsidy on nutritious foods, a tax on less nutritious foods, and a combination of a tax and subsidy on less nutritious and nutritious foods, respectively. The purpose of this study was to examine the general impact of this price difference on purchases of nutritious and less nutritious foods, and whether or not the framing of the price difference had a differential effect on behavior.

Official Title
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Nudging Nutrition: Evaluating the Impact of Monetary Incentives and Environmental Cues on Food Choices

Conditions
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Obesity, Food Labeling, Health Behavior, Diet

Intervention / Treatment
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* Behavioral: Subsidy
* Behavioral: Tax
* Behavioral: Tax and subsidy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Loyalty card shoppers at Hannaford grocery stores Exclusion Criteria: No children in household Less than 75% of food purchases made at Hannaford grocery stores

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Price difference<br>Introduce a 10% price difference between foods labeled as nutritious and foods labeled as less nutritious and frame the price difference as either a Subsidy, Tax, or combination of a Tax and Subsidy. | Behavioral: Subsidy<br>* Frame the price difference as a 10% subsidy on nutritious food items.<br>Behavioral: Tax<br>* Frame the price difference as a 10% tax on less nutritious food items.<br>Behavioral: Tax and subsidy<br>* Frame the price difference as a 5% tax on less nutritious food items and a 5% subsidy on nutritious food items, creating a 10% relative price difference between the types of foods.<br>|
| No Intervention: No price difference<br>No price difference between nutritious and less nutritious foods. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in expenditures on nutritious and less nutritious foods | Item level transaction data were collected for each participant between mid-July 2010 and mid-March 2011. These data included expenditures on all items purchased in the store. Average weekly expenditures were generated and reported in Aug 2011. | 8 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in quantities purchased of nutritious and less nutritious foods | Item level transaction data were collected for each participant between mid-July 2010 and mid-March 2011. These data included quantities of all items purchased in the store. Average weekly quantities purchased were generated and reported in Aug 2011. | 8 months | 
| Change in expenditures on nutritious and less nutritious foods in specific food categories. | Item level transaction data were collected for each participant between mid-July 2010 and mid-March 2011. These data included expenditures on all items purchased in the store, as well as the specific product type. With this information, product groupings can be created, such as for dairy, candy, and fresh produce. Average weekly expenditures for these groupings were generated and reported in July 2012. | 8 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Public policy, Food choice, Nutrition labeling, Fat tax, Vegetable subsidy, Behavioral economics, Health behavior