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Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment

BACKGROUND: Nudging and salient pricing are promising strategies to promote healthy food purchases, but it is possible their effects differ across food groups. OBJECTIVE: To investigate in which food groups nudging and/or pricing strategies most effectively changed product purchases and resulted in...

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Autores principales: Stuber, Josine M, Hoenink, Jody C, Beulens, Joline W J, Mackenbach, Joreintje D, Lakerveld, Jeroen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326041/
https://www.ncbi.nlm.nih.gov/pubmed/33829225
http://dx.doi.org/10.1093/ajcn/nqab057
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author Stuber, Josine M
Hoenink, Jody C
Beulens, Joline W J
Mackenbach, Joreintje D
Lakerveld, Jeroen
author_facet Stuber, Josine M
Hoenink, Jody C
Beulens, Joline W J
Mackenbach, Joreintje D
Lakerveld, Jeroen
author_sort Stuber, Josine M
collection PubMed
description BACKGROUND: Nudging and salient pricing are promising strategies to promote healthy food purchases, but it is possible their effects differ across food groups. OBJECTIVE: To investigate in which food groups nudging and/or pricing strategies most effectively changed product purchases and resulted in within–food groups substitutions or spillover effects. METHODS: In total, 318 participants successfully completed a web-based virtual supermarket experiment in the Netherlands. We conducted a secondary analysis of a mixed randomized experiment consisting of 5 conditions (within subject) and 3 arms (between subject) to investigate the single and combined effects of nudging (e.g., making healthy products salient), taxes (25% price increase), and/or subsidies (25% price decrease) across food groups (fruit and vegetables, grains, dairy, protein products, fats, beverages, snacks, and other foods). Generalized linear mixed models were used to estimate the incidence rate ratios and 95% CIs for changes in the number of products purchased. RESULTS: Compared with the control condition, the combination of subsidies on healthy products and taxes on unhealthy products in the nudging and price salience condition was overall the most effective, as the number of healthy purchases from fruit and vegetables increased by 9% [incidence rate ratio (IRR) = 1.09; 95% CI: 1.02, 1.18], grains by 16% (IRR = 1.16; 95% CI: 1.05, 1.28), and dairy by 58% (IRR = 1.58; 95% CI: 1.31, 1.89), whereas the protein and beverage purchases did not significantly change. Regarding unhealthy purchases, grains decreased by 39% (IRR = 0.72; 95% CI: 0.63, 0.82) and dairy by 30% (IRR = 0.77; 95% CI: 0.68, 0.87), whereas beverage and snack purchases did not significantly change. The groups of grains and dairy showed within–food group substitution patterns toward healthier products. Beneficial spillover effects to minimally targeted food groups were seen for unhealthy proteins (IRR = 0.81; 95% CI: 0.73, 0.91). CONCLUSIONS: Nudging and salient pricing strategies have a differential effect on purchases of a variety of food groups. The largest effects were found for dairy and grains, which may therefore be the most promising food groups to target in order to achieve healthier purchases. The randomized trial on which the current secondary analyses were based is registered in the Dutch trial registry (NTR7293; www.trialregister.nl).
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spelling pubmed-83260412021-08-03 Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment Stuber, Josine M Hoenink, Jody C Beulens, Joline W J Mackenbach, Joreintje D Lakerveld, Jeroen Am J Clin Nutr Original Research Communications BACKGROUND: Nudging and salient pricing are promising strategies to promote healthy food purchases, but it is possible their effects differ across food groups. OBJECTIVE: To investigate in which food groups nudging and/or pricing strategies most effectively changed product purchases and resulted in within–food groups substitutions or spillover effects. METHODS: In total, 318 participants successfully completed a web-based virtual supermarket experiment in the Netherlands. We conducted a secondary analysis of a mixed randomized experiment consisting of 5 conditions (within subject) and 3 arms (between subject) to investigate the single and combined effects of nudging (e.g., making healthy products salient), taxes (25% price increase), and/or subsidies (25% price decrease) across food groups (fruit and vegetables, grains, dairy, protein products, fats, beverages, snacks, and other foods). Generalized linear mixed models were used to estimate the incidence rate ratios and 95% CIs for changes in the number of products purchased. RESULTS: Compared with the control condition, the combination of subsidies on healthy products and taxes on unhealthy products in the nudging and price salience condition was overall the most effective, as the number of healthy purchases from fruit and vegetables increased by 9% [incidence rate ratio (IRR) = 1.09; 95% CI: 1.02, 1.18], grains by 16% (IRR = 1.16; 95% CI: 1.05, 1.28), and dairy by 58% (IRR = 1.58; 95% CI: 1.31, 1.89), whereas the protein and beverage purchases did not significantly change. Regarding unhealthy purchases, grains decreased by 39% (IRR = 0.72; 95% CI: 0.63, 0.82) and dairy by 30% (IRR = 0.77; 95% CI: 0.68, 0.87), whereas beverage and snack purchases did not significantly change. The groups of grains and dairy showed within–food group substitution patterns toward healthier products. Beneficial spillover effects to minimally targeted food groups were seen for unhealthy proteins (IRR = 0.81; 95% CI: 0.73, 0.91). CONCLUSIONS: Nudging and salient pricing strategies have a differential effect on purchases of a variety of food groups. The largest effects were found for dairy and grains, which may therefore be the most promising food groups to target in order to achieve healthier purchases. The randomized trial on which the current secondary analyses were based is registered in the Dutch trial registry (NTR7293; www.trialregister.nl). Oxford University Press 2021-04-07 /pmc/articles/PMC8326041/ /pubmed/33829225 http://dx.doi.org/10.1093/ajcn/nqab057 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Research Communications
Stuber, Josine M
Hoenink, Jody C
Beulens, Joline W J
Mackenbach, Joreintje D
Lakerveld, Jeroen
Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment
title Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment
title_full Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment
title_fullStr Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment
title_full_unstemmed Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment
title_short Shifting toward a healthier dietary pattern through nudging and pricing strategies: A secondary analysis of a randomized virtual supermarket experiment
title_sort shifting toward a healthier dietary pattern through nudging and pricing strategies: a secondary analysis of a randomized virtual supermarket experiment
topic Original Research Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326041/
https://www.ncbi.nlm.nih.gov/pubmed/33829225
http://dx.doi.org/10.1093/ajcn/nqab057
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