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Targeted Food Incentives to Improve Diet Quality and Health Among Adults (Smartcart)

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ClinicalTrials.gov Identifier: NCT03748056
Recruitment Status : Recruiting
First Posted : November 20, 2018
Last Update Posted : November 20, 2018
Sponsor:
Information provided by (Responsible Party):
University of Rhode Island

Brief Summary:
The purpose of this study is to test whether individual-level targeted price incentives for healthier foods can improve the diet quality of grocery purchases made by adults in comparison to a "one size fits all" approach. To test this, the investigators plan to implement a 8-month randomized controlled cross-over trial. The intervention group will receive a small discount for using their loyalty card and weekly coupons for healthier foods (e.g. fruits, vegetables, whole grains, lean meats and seafood, low-fat dairy) that are selected based on the individual's past purchase history, dietary preferences, their baseline diet quality, and their estimated likelihood of using the coupon. Individualized coupons will be automatically sent to customers' loyalty cards each week, and separate emails with appropriate nutrition education and information about the coupons will be sent to participants weekly. The control group will receive a small discount for using their loyalty cards during the first phase of the study (3-months), occasional untargeted coupons, and weekly emails with untargeted nutrition education. Following phase1, there will be a 2-month washout period, and then the intervention and control groups will cross over for the remaining 3-months of the study. The investigators will collect purchase data from all participants as well as food frequency questionnaires and other self-reported behavioral and health questions at baseline, after phase 1 completion, and after phase 2 completion. The investigators hypothesize that participants in the intervention group will meaningfully improve the overall quality of their food purchases (measured using the Grocery Purchase Quality Index-2016) as well as their overall diet quality (measured using the Healthy Eating Index 2010.

Condition or disease Intervention/treatment Phase
Diet Modification Diet Habit Behavioral: Targeted incentives Behavioral: Nominal loyalty card discount and nutrition education Not Applicable

Detailed Description:
A detailed description of Eligibility and outcome measures is entered elsewhere

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 225 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Participant)
Primary Purpose: Prevention
Official Title: Individually-targeted Incentives, Diet Quality, and Health Outcomes Among Adults
Actual Study Start Date : September 10, 2018
Estimated Primary Completion Date : May 1, 2019
Estimated Study Completion Date : May 1, 2019

Arm Intervention/treatment
Experimental: Targeted incentives arm
The interventions received by the experimental group include: 1) weekly emails with targeted coupons for healthier products, 2) weekly emails with targeted nutrition education, and 3) and a nominal discount on grocery purchases for using their loyalty card
Behavioral: Targeted incentives
Participants receiving individually-targeted incentives will receive weekly coupons for healthier foods that are informed by their purchase history, responses to behavioral and health questions, food preferences, and need for improvement in different categories

Behavioral: Nominal loyalty card discount and nutrition education
All participants will receive a nominal discount on all groceries for using their loyalty card and nutrition education through weekly emails.

Active Comparator: Usual care arm
The interventions included under "usual care" include 1) untargeted nutrition education, 2) occasional untargeted coupons for healthier products, and 3) a nominal discount on their grocery purchases for using their loyalty card. These interventions are only received by participants randomized to the usual care arm (rather than the entire population of shoppers), and will allow for testing whether targeting discounts and nutrition education improves the diet quality of purchases in comparison to untargeted approaches.
Behavioral: Nominal loyalty card discount and nutrition education
All participants will receive a nominal discount on all groceries for using their loyalty card and nutrition education through weekly emails.




Primary Outcome Measures :
  1. Likelihood of purchasing targeted products [ Time Frame: 3- 6- and 9-month changes within and between the intervention and control groups ]
    Within produce, whole grain cereals & breads, lean meats, low-fat dairy, and beverages, will look at the proportion of expenditures (i.e. percent of dollars) in those categories before and after the intervention between treatment and control group.

  2. Grocery Purchase Quality Index (GPQI) 2016 [ Time Frame: 3, 6- and 9-month changes in the GPQI-16 and its components within and between the intervention and control groups ]

    The GPQI is a validated measure for scoring the quality of household grocery purchases by comparing the percent spent within different food categories with recommended spending.

    https://utah.pure.elsevier.com/en/publications/the-grocery-purchase-quality-index-2016-an-innovative-approach-to



Secondary Outcome Measures :
  1. Healthy Eating Index (HEI) -2010 for the primary shopper [ Time Frame: 3, 6- and 9-month changes in the HEI-10 and its components within and between the intervention and control groups ]

    The HEI-10 is a validated measure of individual-level diet quality that measures compliance with US Dietary recommendations.

    https://www.ncbi.nlm.nih.gov/pubmed/24453128


  2. Percent expenditures within targeted categories [ Time Frame: 3, 6- and 9-month changes in percent spending in targeted categories within and between the intervention and control groups ]
    The investigators will compute the percent of shopping dollars people spend in fruits, vegetables, whole grains, dairy, lean meat, and seafood.

  3. Self-reported height and weight used to compute body mass index (BMI) [ Time Frame: 3, 6- and 9-month changes in BMI ]
    The investigators will compute body mass index from self-reported weight in pounds and height in inches (weight (lbs) * 703/height (in)/height (in)


Other Outcome Measures:
  1. Self-reported food neophobia as an effect modifier on the primary and secondary outcomes [ Time Frame: Baseline and 9-months ]
    The investigators will examine whether food neophobia modifies the effect of the intervention on the primary and secondary outcomes. Food neophobia was measured via 8 self-reported questions with a 5-point Likert scale ranging from completely disagree to completely agree. Responses will be summed, and higher scores reflect greater variety-seeking in eating experiences (i.e. less neophobia). We will test for an interaction between this continuous measure and the intervention on specified primary and secondary outcomes

  2. Self-reported food literacy as an effect modifier on the primary and secondary outcomes [ Time Frame: Baseline ]
    The investigators will examine whether food literacy modifies the effect of the intervention on the primary and secondary outcomes. Food literacy was measured using a 12-item questionnaire, with 4- and 5-point Likert type scales, with higher scores indicating greater food literacy.

  3. Coupon proneness as an effect modifier on the primary and secondary outcomes [ Time Frame: Baseline and 9-months ]
    The investigators will examine whether coupon proneness modifies the effect of the intervention on the primary and secondary outcomes. Coupon proneness was measured via a 22-item self-reported questionnaire with 7-point Likert scales. Higher scores indicate greater likelihood of using coupons.

  4. Nutritional self-efficacy as a modifier on the primary and secondary outcomes [ Time Frame: Baseline ]
    The investigators will examine whether nutritional self-efficacy modifies the effect of the intervention on the primary and secondary outcomes. Nutrition self-efficacy was measured via self-report using a 5-item scale with Likert responses (range 0-3) with higher scores indicating greater self-efficacy in nutritional domains.

  5. Food security as a modifier on the primary and secondary outcomes [ Time Frame: Baseline and 9-months ]
    The investigators will examine whether food security modifies the effect of the intervention on the primary and secondary outcomes. Household food security was assessed via a 6-item short form, with higher scores indicating greater food insecurity.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • 18 years or older
  • Speaks English
  • Non-store employee
  • Primary shopper in the household
  • Purchases at least half of weekly groceries at supermarket
  • Not pregnant or planning on becoming pregnant before April 2019

Exclusion Criteria:

  • Younger than 18 years of age
  • Does not speak English
  • Employee at supermarket
  • Pregnant or planning to become pregnant before April 2019
  • Not primary shopper for household
  • Purchases less than half of weekly groceries at supermarket

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03748056


Contacts
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Contact: Maya Vadiveloo, PhD Rd 401-874-2992 maya_vadiveloo@uri.edu

Locations
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United States, Rhode Island
University of Rhode Island Recruiting
Kingston, Rhode Island, United States, 02881
Sponsors and Collaborators
University of Rhode Island
Publications:
VAN TRIJP HCM, STEENKAMP J-BEM. Consumers' variety seeking tendency with respect to foods: Measurement and managerial implications. Eur Rev Agric Econ. 1992;19(2):181-195. doi:10.1093/erae/19.2.181.
Lichtenstein, Ridgway, and Netemeyer. (1993) Price perception Scales. Handbook of Marketing Scales.
University of Minnesota. Project EAT - Epidemiology & Community Health Research. http://www.sphresearch.umn.edu/epi/project-eat/#EAT3. Accessed June 14, 2018.

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Responsible Party: University of Rhode Island
ClinicalTrials.gov Identifier: NCT03748056    
Other Study ID Numbers: 1240194-3
AWD05956 , Project 0006418 ( Other Grant/Funding Number: Foundation for Food and Agricultural Research )
First Posted: November 20, 2018    Key Record Dates
Last Update Posted: November 20, 2018
Last Verified: November 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No