Behavioral Economics to Implement Nutrition Ranking in Food Pantries

Study Overview
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Brief Summary
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The goal of this randomized controlled trial is to test whether using behavioral economic strategies to promote healthy food choices on a food bank's online ordering platform increases the use of the traffic light nutrition ranking system and increases healthier food selections by the food agencies (e.g., food pantries) who use the food bank.

Detailed Description
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This study will use behavioral economic strategies to promote utilization of traffic-light nutrition ranking in the Greater Boston Food Bank (GBFB) order system to improve the dietary quality of food ordered by GBFB agencies. Supporting Wellness at Pantries (SWAP) is a program to guide both traffic light labeling for use on ordering platforms and pantry shelves, as well as food pantry layout to inform clients and encourage healthy food choice.This study is a collaboration with the Greater Boston Food Bank (GBFB) to test BE strategies (choice architecture, framing, social norms) for implementation of an evidence-based intervention (traffic light nutrition ranking, SWAP). We will determine if behavioral economic interventions on the GBFB online ordering platform increase agencies' use of traffic light nutrition labels when placing orders and increases their healthy food orders. We will conduct a 12-month randomized controlled trial comparing agencies' ordering experiences and outcomes with the current user interface (control) to a SWAP-enhanced user interface (intervention). All GBFB partner agencies will be randomized to see either the control or intervention interfaces when they log on to ShopGBFB, GBFB's online food ordering platform. In the next phase, the SWAP-enhanced ShopGBFB interface will be updated, adapted, and implemented for all 600 agencies. Outcomes will be monitored for 30 additional months.

Official Title
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Behavioral Economics to Implement a Traffic Light Nutrition Ranking System in a Network of Food Pantries

Conditions
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Food Insecurity, Dietary Quality, Behavioral Economics, Implementation Science

Intervention / Treatment
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* Behavioral: Behavioral economics-enhanced user interface


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Food agencies that order food from the Greater Boston Food Bank (GBFB) online ordering platform. Exclusion Criteria: Food agencies that do not order food from the GBFB online platform within 2 months of the start of the study.

Ages Eligible for Study
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Minimum Age: 18 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

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Food agencies will be randomized to one of two interfaces on the online food bank ordering platform.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Behavioral economics-enhanced user interface<br>Food agencies will see the behavioral economics (BE)-enhanced interface by default; food items will be sorted with green-labeled items listed first, followed by yellow, then red. If users search for a specific item type (e.g., chicken) the results returned for that item type will also be sorted so that green-labeled items are listed first. At any time during the ordering episode, users will have the option to switch from the BE-enhanced default to an alternate sorting or filtering choice, such as alphabetical or cost. Users will be shown the percent of items (by weight) that are labeled green in a prominent location on the ordering screen. The percent green-labeled items in the order will appear alongside messaging reporting the average percent green-labeled items ordered by GBFB pantries that rank in the top 10% based on this metric. | Behavioral: Behavioral economics-enhanced user interface<br>* The intervention changes the ordering platform visible to food agencies using behavioral economics strategies to promote healthier food choices.<br>|
| No Intervention: Usual user interface<br>When agency staff log on to the food bank platform, by default, foods are listed in alphabetical order. If they wish, users can change how items are sorted or filtered using pull-down menus and check-boxes, including the ability to have items sorted or filtered based on traffic light labels. As orders are created, an information section at the top of the page is updated with details on the order weight and cost. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Healthy food agency orders from the food bank | This will be the change from baseline to 12 months in the percentage of foods ordered (by weight) that have green labels. | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of agencies that ever used the traffic light label sorting or filtering when ordering from the food bank | This outcome will be the proportion of agencies in the intervention vs. control group that use the traffic-light sorting/filtering when making orders during the 12 month intervention period. | 12 months |