No abstract

Governments have proposed text warning labels to decrease consumption of sugary drinks-a contributor to chronic diseases such as diabetes. However, they may be less effective than more evocative, graphic warning labels. We field-tested the effectiveness of graphic warning labels (vs. text warning labels, calorie labels, and no labels), provided insight into psychological mechanisms driving effectiveness, and assessed consumer sentiment. Study 1 indicated that graphic warning labels reduced the share of sugary drinks purchased in a cafeteria from 21.4% at baseline to 18.2%-an effect driven by substitution of water for sugary drinks. Study 2 showed that graphic warning labels heighten negative affect and prompt consideration of health consequences. Study 3 indicated that public support for graphic warning labels can be increased by conveying effectiveness information. These findings could spur more effective labeling policies that facilitate healthier choices, do not decrease overall beverage purchases, and are publicly accepted.

Objective: Online grocery shopping could improve access to healthy food, but it may not be equally accessible to all populations—especially those at higher risk for food insecurity. This study aimed to compare the sociodemographic characteristics of families who ordered groceries online versus those who only shopped in-store. Design: We analyzed enrollment survey and 44 weeks of individually-linked grocery transaction data. We used univariate chi-square and t-tests and logistic regression to assess differences in sociodemographic characteristics between households that only shopped in-store and those that shopped online with curbside pick-up (online only or online and in-store). Setting: Two Maine supermarkets. Participants: 863 parents or caregivers of children under 18 years old enrolled in two fruit and vegetable incentive trials Results: Participants had a total of 32 757 transactions. In univariate assessments, online shoppers had higher incomes (P<0.0001), were less likely to participate in WIC or SNAP (P<0.0001), and were more likely to be female (P=0.04). Most online shoppers were 30–39 years old, and few were 50 years or older (P=0.003). After controlling for age, gender, race/ethnicity, number of children, number of adults, income, and SNAP participation, female primary shoppers (OR=2.75, P=0.003), number of children (OR=1.27, P=0.04), and income (OR=3.91 for 186–300% FPL and OR=6.92 for >300% FPL, P<0.0001) were significantly associated with likelihood of shopping online. Conclusions: In this study of Maine families, low-income shoppers were significantly less likely to utilize online grocery ordering with curbside pick-up. Future studies could focus on elucidating barriers and developing strategies to improve access.

OBJECTIVES: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federal program that improves the health of low-income women (pregnant and postpartum) and children up to 5 years of age in the United States. However, participation is suboptimal. We explored reasons for incomplete redemption of benefits and early dropout from WIC. METHODS: In 2020–2021, we conducted semistructured interviews to explore factors that influenced WIC program utilization among current WIC caregivers (n = 20) and caregivers choosing to leave while still eligible (n = 17) in Massachusetts. By using a deductive analytic approach, we developed a codebook grounded in the Consolidated Framework for Implementation Research. RESULTS: Themes across both current and early-leaving participants included positive feelings about social support from the WIC clinic staff and savings offered through the food package. Participants described reduced satisfaction related to insufficient funds for fruits and vegetables, food benefits inflexibility, concerns about in-clinic health tests, and in-store item mislabeling. Participants described how electronic benefit transfer cards and smartphone apps eased the use of benefits and reduced stigma during shopping. Some participants attributed leaving early to a belief that they were taking benefits from others. CONCLUSIONS: Current and early-leaving participants shared positive WIC experiences, but barriers to full participation exist. Food package modification may lead to improved redemption and retention, including increasing the cash value benefit for fruits and vegetables and diversifying food options. Research is needed regarding the misperception that participation means “taking” benefits away from someone else in need.

These findings are directly relevant to future reauthorization of the Child Nutrition Act and to revisions to the implementation time line for the federal school meal standards related to sodium, whole grains, and flavored milk. Insights into FSDs' strategies suggest that more time and targeted technical assistance at federal, state, and local levels is warranted.