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

Abstract

Objective Conduct a pilot study to determine if improving the visibility and quality of fresh produce (choice architecture) in corner stores would increase fruit/vegetable purchases by families participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Design Six stores were randomly assigned to choice architecture intervention or control. Store-level WIC sales data were provided by the state. Primary outcomes were WIC fruit/vegetable voucher and non-fruit/vegetable voucher sales, comparing trends from baseline (December 2012–October 2013) to the five month intervention period (December 2013–April 2014). Secondary outcomes were differences in customer self-reported fruit/vegetable purchases between baseline and the end of intervention. Setting Chelsea, Massachusetts, a low-income urban community. Subjects 575 adult customers completing store exit interviews. Results During baseline, WIC fruit/vegetable and non-fruit/vegetable sales decreased in both the intervention and control stores by $16/month. During the intervention period, WIC fruit/vegetable sales increased in intervention stores by $40/month but decreased in control stores by $23/month (difference in trends $63/month, 95% CI, $4–121/month; p=0.036); WIC non-fruit/vegetable sales were not different (p=0.45). Comparing baseline to intervention period exit interview responses by customers participating in WIC (N=134), intervention store customers reported increased fruit/vegetable purchases compared to control store customers (18% vs. −2%), but this did not achieve statistical significance (p=0.11). Conclusions Placement of fruit/vegetables near the front of corner stores increased purchase of produce by customers using WIC. New policies that incentivize stores to stock and prominently display good quality produce could promote healthier food choices of low-income families.

A systematic review and meta-analysis of the effectiveness of nudging to increase fruit and vegetable choice

“…The latter used a fake food buffet, 13 a Foodscape Laboratory 26 and an online shelf-display. 27 In the field studies, different settings were involved, including dining facilities or cafeterias in schools (11), cafeterias in hospitals (2) as well as restaurants, buffet lines at conferences (2; 28,29 ), a cafeteria at a workplace, 30 a university, 31 a train station, 32 corner stores 33 and a swimming pool. 34 Most studies used a within subjects pre-post interventions design (10), or a between subjects design with a control and treatment group (9), while a minority used both a between-and within subjects design (4).…”

Fruit and Vegetable Purchases in Farmer’s Market Stands: Analysing Survey and Sales Data

“…Other farmers' market studies analyse self-reported use of government incentive programs, government incentive sales data or records of coupon redemption [61][62][63][64][65][66], self-reported amounts spent [67] or total sales [39]. Some studies on convenience stores use purchase data collected using these same methods [68][69][70][71][72][73][74][75]. Given technological advances and changing legal requirements [76] in tracking sales, point of sales (POS) terminals are starting to gain popularity in UPS.…”

Evaluation of Store Environment Changes of an In-Store Intervention to Promote Fruits and Vegetables in Latino/Hispanic-Focused Food Stores

“…Another study reported observing changes in POP signs at mid-intervention and post-intervention [28]. However, unlike other intervention studies, El Valor was not successful in capturing changes in other aspects of the marketing mix elements such as the availability of fresh, canned, and frozen FVs, shelf space dedicated to fresh FVs, and fresh FV displays [11,21,23,24,26,[53][54][55]. For example, two previous in-store interventions reported successful increases in the availability of fresh and/or canned FVs [53,56], while another study reported success in replacing shelf space dedicated to snack foods with shelf space dedicated to FVs [11].…”