A Default Option for Health: Improving Nutrition Within the Financial and Geographic Constraints of Food Insecurity

University at Albany

Status: Completed

Conditions: Food Selection; Obesity

Treatments: Behavioral: Nutrition Education; Behavioral: Default Option

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT04186533

17-E-224-01

Details and patient eligibility

About

Food insecurity is associated with an increased risk of obesity. The availability of a default option (i.e., option a consumer selects if no active choice is made) has been shown to effectively nudge consumer behavior. An online default option (i.e., prefilled grocery shopping cart) was previously shown to positively impact the food purchases of individuals with food insecurity.The present study aims to extend these findings bye examining efficacy of an online default option in enhancing the nutritional quality of online grocery purchases in individuals with food insecurity over the course of a month.

Full description

Food insecurity is associated with an increased risk of obesity and weight-related illnesses. The present study is the first longitudinal randomized control trial to examine if an online prefilled grocery shopping cart (i.e., a default cart) nudges individuals with food insecurity to purchase healthier groceries compared to receiving nutrition education.

It was hypothesized that the prefilled online grocery shopping cart (i.e., default condition) will result in a significant improvement in the nutritional quality of groceries purchased compared to those receiving nutrition education.

Thirty-eight food pantry users recruited from food pantries in New York in 2018 were enrolled in the present study and were given $48.50 to purchase groceries weekly using an online grocery website for five weeks. At baseline, participants were instructed to purchase groceries keeping in mind nutrition, cost, and taste. For the subsequent four weeks (T1-T4), participants were randomized to receive 1) nutrition education or 2) a prefilled online grocery shopping cart that met their nutritional needs based on age and sex (Default).

Our primary nutritional outcomes included HEI scores, calories (kcal), and energy density (kcal/grams).

Enrollment: 38 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

1. At least 18 years old
2. Residing in a single person household
3. Receiving assistance at a food pantry
4. Able to read and write in English
5. Able to provide informed consent
6. Current residence in a zip code served by Price Chopper's delivery program
7. None of the following dietary restrictions: Vegetarian/vegan, Gluten-free/celiacs, Lactose intolerance, egg allergy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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38 participants in 2 patient groups

Default Intervention

Experimental group

Description:

Participants in the default condition were presented with a pre-filled online shopping cart containing a combination of groceries that meet macro- and micronutrient requirements for their gender and age, and told that they are free to delete, add, and exchange any item they wish to finalize their selections.

Treatment:

Behavioral: Default Option

Nutrition Education

Active Comparator group

Description:

Participants in the nutrition education condition were instructed to read brief nutrition education handouts before online grocery shopping.

Treatment:

Behavioral: Nutrition Education