Diet Habit
Conditions
Brief summary
The specific aims of this proposal are to 1) develop the components of a behavioral economics strategy (i.e., healthy bundle defaults) to influence diet behaviors; 2) characterize the online grocery shopping behaviors and attitudes of low-income adults nationally; and 3) examine the extent to which healthy bundles defaults and other behavioral economic strategies increase fruit and vegetable purchases among low-income adults in an online randomized controlled experiment.
Interventions
BEHAVIORALSimulated Grocery Shopping Exercise
Participants will click a link and simulate a shopping experience by selecting a week's worth of Supplemental Nutrition Assistance Program (SNAP)-eligible groceries for their household in a web-based supermarket platform
Sponsors
National Institute on Aging (NIA)
NYU Langone Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
Yes
Inclusion criteria
* aged 18-99 years * ability to read and speak English * have ever received SNAP benefits * live with fewer than 5 people * access to a personal computer, laptop, tablet, or mobile phone.
Exclusion criteria
* aged \<18 years or \>99 years * lack the ability to read and speak English * have never received SNAP benefits * live with 5 or more people * do not have access to a personal computer, laptop, tablet, or mobile phone
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Real Dollars Spent on Fruit and Vegetables Per Basket | Day 1 | Fruits and vegetables are defined as frozen, fresh, and canned fruits and vegetables without added sugars, fats, oils, or salt. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Real Dollars Spent on Eligible Fruits Only | Day 1 | Eligible Fruits are defined as fruit items identified as discounted in the online store. |
| Real Dollars Spent on Eligible Vegetables Only | Day 1 | Eligible Vegetables are defined as vegetable items identified as discounted in the online store. |
| Real Dollars Spent on Eligible Fresh Fruits and Vegetables | Day 1 | Eligible Fresh Fruits and Vegetables are defined as fresh, not frozen or canned, fruit and vegetables items identified as discounted in the online store. |
| Real Dollars Spent on Eligible Frozen Fruits and Vegetables | Day 1 | Eligible Frozen Fruits and Vegetables are defined as frozen fruit and vegetables items identified as discounted in the online store. |
| Real Dollars Spent on Eligible Canned Fruits and Vegetables | Day 1 | Eligible Canned Fruits and Vegetables are defined as canned fruit and vegetables items identified as discounted in the online store. |
| Total Calories From Fruits and Vegetables Per Basket | Day 1 | Fruits and vegetables are defined as frozen, fresh, and canned fruits and vegetables without added sugars, fats, oils, or salt. |
| Number of Participants Who Purchased Fruits and/or Vegetables | Day 1 | Participants who purchased fruits and/or vegetables during their online shopping trip. |
| Number of Participants Who Kept Healthy Bundle Default Shopping Cart Items in Basket at Purchase | Day 1 | Healthy Bundle Default Shopping Cart Items are defined as items placed automatically in participants' carts at the beginning of the shopping exercise. Assessed among participants in the Bundles (Arm 3) and Bundles + Discount (Arm 4) arms only. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Control The grocery shopping simulation will not include any discounts or bundles
Simulated Grocery Shopping Exercise: Participants will click a link and simulate a shopping experience by selecting a week's worth of SNAP-eligible groceries for their household in a web-based supermarket platform | 649 |
| Discount The grocery shopping simulation will include discount on eligible fruits and vegetables
Simulated Grocery Shopping Exercise: Participants will click a link and simulate a shopping experience by selecting a week's worth of SNAP-eligible groceries for their household in a web-based supermarket platform | 682 |
| Bundles The grocery shopping simulation will include healthy bundle defaults with no discount
Simulated Grocery Shopping Exercise: Participants will click a link and simulate a shopping experience by selecting a week's worth of SNAP-eligible groceries for their household in a web-based supermarket platform | 727 |
| Bundles and Discount The grocery shopping simulation will include healthy bundle defaults plus a discount
Simulated Grocery Shopping Exercise: Participants will click a link and simulate a shopping experience by selecting a week's worth of SNAP-eligible groceries for their household in a web-based supermarket platform | 686 |
| Total | 2,744 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 |
|---|---|---|---|---|---|---|
| Aim 2 - Pre-Randomization Survey | Did not finish survey | 0 | 0 | 0 | 0 | 120 |
| Aim 2 - Pre-Randomization Survey | Never been enrolled in SNAP and/or live in a household with at least 4 people | 0 | 0 | 0 | 0 | 3,752 |
| Aim 3 - Randomization/Online Shopping | Did not finish the shopping task | 206 | 223 | 155 | 198 | 0 |
| Aim 3 - Randomization/Online Shopping | Reused same IP address, and/or finished the survey in under one-third of median completion time | 67 | 86 | 75 | 84 | 0 |
Baseline characteristics
| Characteristic | Control | Total | Bundles and Discount | Bundles | Discount |
|---|---|---|---|---|---|
| Age, Continuous | 45.9 years STANDARD_DEVIATION 15.4 | 46.7 years STANDARD_DEVIATION 16 | 46.7 years STANDARD_DEVIATION 16.1 | 47.0 years STANDARD_DEVIATION 16.3 | 47.2 years STANDARD_DEVIATION 16.1 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 63 Participants | 269 Participants | 64 Participants | 75 Participants | 67 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 566 Participants | 2364 Participants | 582 Participants | 602 Participants | 614 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 20 Participants | 111 Participants | 40 Participants | 50 Participants | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 9 Participants | 39 Participants | 6 Participants | 6 Participants | 18 Participants |
| Race (NIH/OMB) Asian | 13 Participants | 49 Participants | 16 Participants | 10 Participants | 10 Participants |
| Race (NIH/OMB) Black or African American | 99 Participants | 390 Participants | 107 Participants | 93 Participants | 91 Participants |
| Race (NIH/OMB) More than one race | 16 Participants | 55 Participants | 7 Participants | 4 Participants | 28 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 2 Participants | 524 Participants | 4 Participants | 2 Participants | 516 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 20 Participants | 111 Participants | 40 Participants | 50 Participants | 1 Participants |
| Race (NIH/OMB) White | 490 Participants | 1576 Participants | 506 Participants | 562 Participants | 18 Participants |
| Region of Enrollment United States | 649 participants | 2744 participants | 686 participants | 727 participants | 682 participants |
| Sex: Female, Male Female | 344 Participants | 1447 Participants | 361 Participants | 396 Participants | 346 Participants |
| Sex: Female, Male Male | 305 Participants | 1297 Participants | 325 Participants | 331 Participants | 336 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 649 | 0 / 682 | 0 / 727 | 0 / 686 |
| other Total, other adverse events | 0 / 649 | 0 / 682 | 0 / 727 | 0 / 686 |
| serious Total, serious adverse events | 0 / 649 | 0 / 682 | 0 / 727 | 0 / 686 |
Outcome results
Primary
Real Dollars Spent on Fruit and Vegetables Per Basket
Fruits and vegetables are defined as frozen, fresh, and canned fruits and vegetables without added sugars, fats, oils, or salt.
Time frame: Day 1
Population: Not all participants analyzed purchased fruits and vegetables, as quantified in SECONDARY OUTCOME MEASURE RESULTS #8. However, all participants contributed data to this outcome as they could still purchase $0 or 0% of their total dollars on fruits and vegetables.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control | Real Dollars Spent on Fruit and Vegetables Per Basket | 11.31 US Dollars ($) | Standard Deviation 12.82 |
| Discount | Real Dollars Spent on Fruit and Vegetables Per Basket | 15.27 US Dollars ($) | Standard Deviation 16.08 |
| Bundles | Real Dollars Spent on Fruit and Vegetables Per Basket | 11.68 US Dollars ($) | Standard Deviation 11.36 |
| Bundles and Discount | Real Dollars Spent on Fruit and Vegetables Per Basket | 14.47 US Dollars ($) | Standard Deviation 14.18 |
Secondary
Number of Participants Who Kept Healthy Bundle Default Shopping Cart Items in Basket at Purchase
Healthy Bundle Default Shopping Cart Items are defined as items placed automatically in participants' carts at the beginning of the shopping exercise. Assessed among participants in the Bundles (Arm 3) and Bundles + Discount (Arm 4) arms only.
Time frame: Day 1
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Control | Number of Participants Who Kept Healthy Bundle Default Shopping Cart Items in Basket at Purchase | 679 Participants |
| Discount | Number of Participants Who Kept Healthy Bundle Default Shopping Cart Items in Basket at Purchase | 655 Participants |
Secondary
Number of Participants Who Purchased Fruits and/or Vegetables
Participants who purchased fruits and/or vegetables during their online shopping trip.
Time frame: Day 1
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Control | Number of Participants Who Purchased Fruits and/or Vegetables | 550 Participants |
| Discount | Number of Participants Who Purchased Fruits and/or Vegetables | 612 Participants |
| Bundles | Number of Participants Who Purchased Fruits and/or Vegetables | 714 Participants |
| Bundles and Discount | Number of Participants Who Purchased Fruits and/or Vegetables | 678 Participants |
Secondary
Real Dollars Spent on Eligible Canned Fruits and Vegetables
Eligible Canned Fruits and Vegetables are defined as canned fruit and vegetables items identified as discounted in the online store.
Time frame: Day 1
Population: Not all participants analyzed purchased eligible canned fruits and vegetables, as quantified in SECONDARY OUTCOME MEASURE RESULTS #8. However, all participants contributed data to this outcome as they could still purchase $0 or 0% of their total dollars on eligible canned fruits and vegetables.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control | Real Dollars Spent on Eligible Canned Fruits and Vegetables | 0.22 US Dollars ($) | Standard Deviation 0.92 |
| Discount | Real Dollars Spent on Eligible Canned Fruits and Vegetables | 0.27 US Dollars ($) | Standard Deviation 1.2 |
| Bundles | Real Dollars Spent on Eligible Canned Fruits and Vegetables | 0.13 US Dollars ($) | Standard Deviation 0.65 |
| Bundles and Discount | Real Dollars Spent on Eligible Canned Fruits and Vegetables | 0.16 US Dollars ($) | Standard Deviation 0.75 |
Secondary
Real Dollars Spent on Eligible Fresh Fruits and Vegetables
Eligible Fresh Fruits and Vegetables are defined as fresh, not frozen or canned, fruit and vegetables items identified as discounted in the online store.
Time frame: Day 1
Population: Not all participants analyzed purchased eligible fresh fruits and vegetables, as quantified in SECONDARY OUTCOME MEASURE RESULTS #8. However, all participants contributed data to this outcome as they could still purchase $0 or 0% of their total dollars on eligible fresh fruits and vegetables.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control | Real Dollars Spent on Eligible Fresh Fruits and Vegetables | 9.61 US Dollars ($) | Standard Deviation 11.83 |
| Discount | Real Dollars Spent on Eligible Fresh Fruits and Vegetables | 12.94 US Dollars ($) | Standard Deviation 14.56 |
| Bundles | Real Dollars Spent on Eligible Fresh Fruits and Vegetables | 10.49 US Dollars ($) | Standard Deviation 10.67 |
| Bundles and Discount | Real Dollars Spent on Eligible Fresh Fruits and Vegetables | 12.48 US Dollars ($) | Standard Deviation 12.51 |
Secondary
Real Dollars Spent on Eligible Frozen Fruits and Vegetables
Eligible Frozen Fruits and Vegetables are defined as frozen fruit and vegetables items identified as discounted in the online store.
Time frame: Day 1
Population: Not all participants analyzed purchased eligible frozen fruits and vegetables, as quantified in SECONDARY OUTCOME MEASURE RESULTS #8. However, all participants contributed data to this outcome as they could still purchase $0 or 0% of their total dollars on eligible frozen fruits and vegetables.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control | Real Dollars Spent on Eligible Frozen Fruits and Vegetables | 1.48 US Dollars ($) | Standard Deviation 4.01 |
| Discount | Real Dollars Spent on Eligible Frozen Fruits and Vegetables | 2.07 US Dollars ($) | Standard Deviation 5.49 |
| Bundles | Real Dollars Spent on Eligible Frozen Fruits and Vegetables | 1.05 US Dollars ($) | Standard Deviation 3.23 |
| Bundles and Discount | Real Dollars Spent on Eligible Frozen Fruits and Vegetables | 1.83 US Dollars ($) | Standard Deviation 5.38 |
Secondary
Real Dollars Spent on Eligible Fruits Only
Eligible Fruits are defined as fruit items identified as discounted in the online store.
Time frame: Day 1
Population: Not all participants analyzed purchased eligible fruits, as quantified in SECONDARY OUTCOME MEASURE RESULTS #8. However, all participants contributed data to this outcome as they could still purchase $0 or 0% of their total dollars on eligible fruits.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control | Real Dollars Spent on Eligible Fruits Only | 4.28 US Dollars ($) | Standard Deviation 7.14 |
| Discount | Real Dollars Spent on Eligible Fruits Only | 6.51 US Dollars ($) | Standard Deviation 9.94 |
| Bundles | Real Dollars Spent on Eligible Fruits Only | 4.85 US Dollars ($) | Standard Deviation 6.78 |
| Bundles and Discount | Real Dollars Spent on Eligible Fruits Only | 6.12 US Dollars ($) | Standard Deviation 7.91 |
Secondary
Real Dollars Spent on Eligible Vegetables Only
Eligible Vegetables are defined as vegetable items identified as discounted in the online store.
Time frame: Day 1
Population: Not all participants analyzed purchased eligible vegetables, as quantified in SECONDARY OUTCOME MEASURE RESULTS #8. However, all participants contributed data to this outcome as they could still purchase $0 or 0% of their total dollars on eligible vegetables.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control | Real Dollars Spent on Eligible Vegetables Only | 7.03 US Dollars ($) | Standard Deviation 9.34 |
| Discount | Real Dollars Spent on Eligible Vegetables Only | 8.76 US Dollars ($) | Standard Deviation 11.04 |
| Bundles | Real Dollars Spent on Eligible Vegetables Only | 6.84 US Dollars ($) | Standard Deviation 7.93 |
| Bundles and Discount | Real Dollars Spent on Eligible Vegetables Only | 8.34 US Dollars ($) | Standard Deviation 9.94 |
Secondary
Total Calories From Fruits and Vegetables Per Basket
Fruits and vegetables are defined as frozen, fresh, and canned fruits and vegetables without added sugars, fats, oils, or salt.
Time frame: Day 1
Population: Not all participants analyzed purchased fruits and vegetables, as quantified in SECONDARY OUTCOME MEASURE RESULTS #8. However, all participants contributed data to this outcome as they could still contribute 0 calories from fruits and vegetables in their basket.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control | Total Calories From Fruits and Vegetables Per Basket | 1298.1 Kcal | Standard Deviation 1595 |
| Discount | Total Calories From Fruits and Vegetables Per Basket | 1526.2 Kcal | Standard Deviation 1641.3 |
| Bundles | Total Calories From Fruits and Vegetables Per Basket | 1496.8 Kcal | Standard Deviation 1472.8 |
| Bundles and Discount | Total Calories From Fruits and Vegetables Per Basket | 1690.5 Kcal | Standard Deviation 1572 |