Reducing cardiometabolic risk in adults with a low socioeconomic position: protocol of the Supreme Nudge parallel cluster-randomised controlled supermarket trial

Stuber, Josine M; Mackenbach, Joreintje D.; Boer, Femke E. de; Bruijn, Gert-Jan de; Gillebaart, Marleen; Harbers, Marjolein C.; Hoenink, Jody C.; Klein, Michel; Middel, Cédric N.H.; Schouw, Yvonne T. van der; Schuitmaker-Warnaar, Tjerk Jan; Velema, Elizabeth; Vos, Anne L.; Waterlander, Wilma; Lakerveld, Jeroen; Beulens, Joline W.J.

doi:10.1186/s12937-020-00562-8

Cited by 12 publications

(15 citation statements)

References 107 publications

(119 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, further research into the single and combined effects of nudging and pricing strategies (especially price increases) in real-world settings and on long-term disease outcomes is needed. Therefore, we are currently planning on conducting an intervention within the Supreme Nudge project which aims to investigate the effect of nudging and pricing strategies on cardiometabolic disease risk in adults with a low SEP [25]. The pricing strategies of this real-life study will include a price reduction of 25% on healthy foods and a price difference of 25% between unhealthy products and their healthier substitutes within the same food group (e.g., white bread and whole-grain bread) [25].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we are currently planning on conducting an intervention within the Supreme Nudge project which aims to investigate the effect of nudging and pricing strategies on cardiometabolic disease risk in adults with a low SEP [25]. The pricing strategies of this real-life study will include a price reduction of 25% on healthy foods and a price difference of 25% between unhealthy products and their healthier substitutes within the same food group (e.g., white bread and whole-grain bread) [25]. Next to investigating the effect of pricing and nudging strategies in real-world settings, further research should investigate possible differential effects of nudging and pricing strategies by factors influencing purchasing habits (e.g., single-member households, age, impulsiveness and price sensitivity).…”

Section: Discussionmentioning

confidence: 99%

“…Participants were randomized into one of the three study arms (25% price increases, 25% price discounts, or 25% price increases and discounts) and within these arms exposed to five study conditions (control, nudging, pricing, price salience and price salience with nudging). A 25% price change was chosen based on the finding that at least a 20% price change is needed to result in significant effects on population health [24] and based on discussions with a Dutch supermarket chain regarding what price changes would be feasible in real-world supermarkets [25]. The order in which the participants received the five study conditions was also randomized.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

The effects of nudging and pricing on healthy food purchasing behavior in a virtual supermarket setting: a randomized experiment

Hoenink

Mackenbach

Waterlander

et al. 2020

Int J Behav Nutr Phys Act

Self Cite

View full text Add to dashboard Cite

Background: Evidence on what strategies-or combination of strategies-are most effective and equitable in promoting healthier diets is needed. This study examined the efficacy of nudging and pricing strategies on increasing healthy food purchases and the potential differential effect by socioeconomic position (SEP) among Dutch adults in a virtual supermarket. Methods: A randomized study design was conducted within a virtual supermarket (SN VirtuMart). Participants were exposed to five within-subject study conditions (control, nudging, pricing, price salience and price salience with nudging) and randomized to one of three between-subject study arms (a 25% price increase on unhealthy products, a 25% discount on healthy products, or a 25% price increase and discount). In total, 455 participants of low and high SEP (using either education or income as proxy) were randomized to conduct their weekly shopping in a virtual supermarket for five consecutive weeks. The primary outcome included the percentage of healthy purchases. Data were analyzed using linear mixed models. Results: In total, 346 (76%) adults completed all five shops within the SN VirtuMart. Median age was 32.5, 49.2% had high education and 32.8% had high income. Out of the 12 conditions, four conditions were statistically significantly different from the control condition. Nudging and non-salient pricing strategies alone did not statistically significantly increase healthy food purchases, whereas a combination of salient price increases and discounts led to an increase in the percentage of healthy food purchases (B 4.5, 95%CI 2.6; 6.4). Combining salient pricing and nudging strategies led to increases in the percentage of healthy products in all three pricing arms, with largest effects found in the combined price increase and discount arm (B = 4.0, 95%CI = 2.0; 6.0). Effects were not modified by SEP.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The effects of nudging and pricing on healthy food purchasing behavior in a virtual supermarket setting: a randomized experiment

Hoenink

Mackenbach

Waterlander

et al. 2020

Int J Behav Nutr Phys Act

Self Cite

View full text Add to dashboard Cite

show abstract

“…The information nudge was implemented on healthy products and highlighted specific product information [ 6 ]. It was developed following a co-creation process with the supermarket chain, as part of the Supreme Nudge supermarket trial [ 29 , 30 ]. Consequently, the layout of the information nudge corresponded with the supermarket chain’s corporate identity.…”

Section: Methodsmentioning

confidence: 99%

Nudging customers towards healthier food and beverage purchases in a real-life online supermarket: a multi-arm randomized controlled trial

Stuber

Lakerveld

Kievitsbosch

et al. 2022

BMC Med

Self Cite

View full text Add to dashboard Cite

Background Nudging is increasingly used to promote healthy food choices in supermarkets. Ordering groceries online is gaining in popularity and nudging seems efficacious there as well, but is never comprehensively tested in real-life. We evaluated the real-life effectiveness of nudging in an online supermarket on healthy food purchases. Methods We conducted a multi-arm, parallel-group, individually randomized controlled trial in an online supermarket. During 1 month, all customers were randomized to (1) control condition, (2) information nudges, (3) position nudges, and (4) information and position nudges combined. Allocation was concealed and customers were not blinded, but unaware of the intervention. Mean differences between the control condition and the intervention arms in the total percentage of healthy purchases were assessed with a linear mixed model. We tested for effect modification by area-level deprivation. Results Based on sales data from 11,775 shoppers, no overall significant effects were detected. Yet, effects were modified by area-level deprivation (pArm 2 < 0.001). Among shoppers from deprived areas, those allocated to information nudges purchased a 2.4% (95%CI 0.8, 4.0) higher percentage of healthy products compared to controls. No significant differences were observed for position (− 1.3%; 95%CI − 2.8, 0.3) and combined nudges (− 0.1%; 95%CI − 1.7, 1.5). Shoppers from non-deprived areas exposed to information nudges (− 1.6%; 95%CI − 3.2, − 0.1) and the combined nudges (− 2.1%; 95%CI − 3.6, − 0.6), but not position nudges (− 0.9%; 95%CI − 2.4, 0.7), purchased a lower percentage of healthy products. Conclusion Information nudges in an online supermarket can increase healthy product purchases, but only for those living in deprived areas. The adverse effects found on purchasing behaviors for those from non-deprived areas call for further research. Further research should also focus on real-life effects of online healthy food nudging as part of a broader nutrition intervention strategy, and on the equitability of the online nudging intervention within populations. Trial registration Retrospectively registered in the ISRCTN registry at May 21, 2021 (ISRCTN10491616).

show abstract

“…The SUPREME NUDGE project aims to improve lifestyle behaviours and lower cardiometabolic risk among adults with low SEP through implementing nudging and pricing strategies in a real-life supermarket setting [ 20 ]. For the design of the nudges in this project, we aimed to explore how the determinants of food choice shape the perceptions regarding supermarket-based nudging strategies among adults with low SEP, in order to better inform the design of the nudges.…”

Section: Introductionmentioning

confidence: 99%

Determinants of Food Choice and Perceptions of Supermarket-Based Nudging Interventions among Adults with Low Socioeconomic Position: The SUPREME NUDGE Project

Harbers

Middel²,

Stuber

et al. 2021

IJERPH

Self Cite

View full text Add to dashboard Cite

Nudging has received ample attention in scientific literature as an environmental strategy to promote healthy diets, and may be effective for reaching populations with low socioeconomic position (SEP). Therefore, the objective of this study was to investigate how the determinants of food choice shape the perceptions regarding supermarket-based nudging strategies among adults with low SEP. We conducted semi-structured interviews among fifteen adults with low SEP using a pre-defined topic list and visual examples of nudges. Interviews were recorded and transcribed verbatim and content analysis was used to analyse the data. The results show that food costs, convenience, healthiness, taste, and habits were frequently mentioned as determinants of food choice. However, the relative importance of these determinants seemed to be context-dependent. Interviewees generally had a positive attitude towards nudges, especially when they were aligned with product preferences, information needs, and beliefs about the food environment. Still, some interviewees also expressed distrust towards nudging strategies, suspecting ulterior motives. We conclude that nudging strategies should target foods which align with product preferences and information needs. However, the suspicion of ulterior motives highlights an important concern which should be considered when implementing supermarket-based nudging strategies.

show abstract

Reducing cardiometabolic risk in adults with a low socioeconomic position: protocol of the Supreme Nudge parallel cluster-randomised controlled supermarket trial

Cited by 12 publications

References 107 publications

The effects of nudging and pricing on healthy food purchasing behavior in a virtual supermarket setting: a randomized experiment

The effects of nudging and pricing on healthy food purchasing behavior in a virtual supermarket setting: a randomized experiment

Nudging customers towards healthier food and beverage purchases in a real-life online supermarket: a multi-arm randomized controlled trial

Determinants of Food Choice and Perceptions of Supermarket-Based Nudging Interventions among Adults with Low Socioeconomic Position: The SUPREME NUDGE Project

Contact Info

Product

Resources

About