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NCT Number: NCT03748056

Targeted Food Incentives to Improve Diet Quality and Health Among Adults

The purpose of this study is to test whether individual-level targeted price incentives for healthier foods can improve the diet quality of grocery purchases made by adults in comparison to a "one size fits all" approach. To test this, the investigators plan to implement a 8-month randomized controlled cross-over trial. The intervention group will receive a small discount for using their loyalty card and weekly coupons for healthier foods (e.g. fruits, vegetables, whole grains, lean meats and seafood, low-fat dairy) that are selected based on the individual's past purchase history, dietary preferences, their baseline diet quality, and their estimated likelihood of using the coupon. Individualized coupons will be automatically sent to customers' loyalty cards each week, and separate emails with appropriate nutrition education and information about the coupons will be sent to participants weekly. The control group will receive a small discount for using their loyalty cards during the first phase of the study (3-months), occasional untargeted coupons, and weekly emails with untargeted nutrition education. Following phase1, there will be a 2-month washout period, and then the intervention and control groups will cross over for the remaining 3-months of the study. The investigators will collect purchase data from all participants as well as food frequency questionnaires and other self-reported behavioral and health questions at baseline, after phase 1 completion, and after phase 2 completion. The investigators hypothesize that participants in the intervention group will meaningfully improve the overall quality of their food purchases (measured using the Grocery Purchase Quality Index-2016) as well as their overall diet quality (measured using the Healthy Eating Index 2010.

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Key information

Conditions

Diet Modification Behavior Behavior, Animal Diet Habit Feeding Behavior

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Rhode Island

Kingston, Rhode Island, 02881, United States

About this study

A detailed description of Eligibility and outcome measures is entered elsewhere

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 18 years or older
  • Speaks English
  • Non-store employee
  • Primary shopper in the household
  • Purchases at least half of weekly groceries at supermarket
  • Not pregnant or planning on becoming pregnant before April 2019

Exclusion criteria

  • Younger than 18 years of age
  • Does not speak English
  • Employee at supermarket
  • Pregnant or planning to become pregnant before April 2019
  • Not primary shopper for household
  • Purchases less than half of weekly groceries at supermarket

Treatment and study plan

Targeted incentives

Behavioral

Participants receiving individually-targeted incentives will receive weekly coupons for healthier foods that are informed by their purchase history, responses to behavioral and health questions, food preferences, and need for improvement in different categories

Nominal loyalty card discount and nutrition education

Behavioral

All participants will receive a nominal discount on all groceries for using their loyalty card and nutrition education through weekly emails.

Primary outcomes

  1. Likelihood of purchasing targeted products

    Time frame: 3- 6- and 9-month changes within and between the intervention and control groups

    Within produce, whole grain cereals & breads, lean meats, low-fat dairy, and beverages, will look at the proportion of expenditures (i.e. percent of dollars) in those categories before and after the intervention between treatment and control group.

  2. Grocery Purchase Quality Index (GPQI) 2016

    Time frame: 3, 6- and 9-month changes in the GPQI-16 and its components within and between the intervention and control groups

    The GPQI is a validated measure for scoring the quality of household grocery purchases by comparing the percent spent within different food categories with recommended spending.

    https://utah.pure.elsevier.com/en/publications/the-grocery-purchase-quality-index-2016-an-innovative-approach-to

Secondary outcomes

  1. Healthy Eating Index (HEI) -2010 for the primary shopper

    Time frame: 3, 6- and 9-month changes in the HEI-10 and its components within and between the intervention and control groups

    The HEI-10 is a validated measure of individual-level diet quality that measures compliance with US Dietary recommendations.

    https://www.ncbi.nlm.nih.gov/pubmed/24453128

  2. Percent expenditures within targeted categories

    Time frame: 3, 6- and 9-month changes in percent spending in targeted categories within and between the intervention and control groups

    The investigators will compute the percent of shopping dollars people spend in fruits, vegetables, whole grains, dairy, lean meat, and seafood.

  3. Self-reported height and weight used to compute body mass index (BMI)

    Time frame: 3, 6- and 9-month changes in BMI

    The investigators will compute body mass index from self-reported weight in pounds and height in inches (weight (lbs) * 703/height (in)/height (in)

Other outcomes

  1. Self-reported food neophobia as an effect modifier on the primary and secondary outcomes

    Time frame: Baseline and 9-months

    The investigators will examine whether food neophobia modifies the effect of the intervention on the primary and secondary outcomes. Food neophobia was measured via 8 self-reported questions with a 5-point Likert scale ranging from completely disagree to completely agree. Responses will be summed, and higher scores reflect greater variety-seeking in eating experiences (i.e. less neophobia). We will test for an interaction between this continuous measure and the intervention on specified primary and secondary outcomes

  2. Self-reported food literacy as an effect modifier on the primary and secondary outcomes

    Time frame: Baseline

    The investigators will examine whether food literacy modifies the effect of the intervention on the primary and secondary outcomes. Food literacy was measured using a 12-item questionnaire, with 4- and 5-point Likert type scales, with higher scores indicating greater food literacy.

  3. Coupon proneness as an effect modifier on the primary and secondary outcomes

    Time frame: Baseline and 9-months

    The investigators will examine whether coupon proneness modifies the effect of the intervention on the primary and secondary outcomes. Coupon proneness was measured via a 22-item self-reported questionnaire with 7-point Likert scales. Higher scores indicate greater likelihood of using coupons.

  4. Nutritional self-efficacy as a modifier on the primary and secondary outcomes

    Time frame: Baseline

    The investigators will examine whether nutritional self-efficacy modifies the effect of the intervention on the primary and secondary outcomes. Nutrition self-efficacy was measured via self-report using a 5-item scale with Likert responses (range 0-3) with higher scores indicating greater self-efficacy in nutritional domains.

  5. Food security as a modifier on the primary and secondary outcomes

    Time frame: Baseline and 9-months

    The investigators will examine whether food security modifies the effect of the intervention on the primary and secondary outcomes. Household food security was assessed via a 6-item short form, with higher scores indicating greater food insecurity.

Sponsors and collaborators

Lead sponsor

University of Rhode Island

Other

Registry information

Official study title

Individually-targeted Incentives, Diet Quality, and Health Outcomes Among Adults

Acronym: Smartcart

Important dates

Study start
2018
Primary completion
2019
Study completion
2019
First posted
Nov 20, 2018
Registry last updated
Oct 1, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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