Do effects of price discounts and nutrition education on food purchases vary by ethnicity, income and education? Results from a randomised, controlled trial
Do effects of price discounts and nutrition education on food purchases vary by ethnicity, income and education? Results from a randomised, controlled trial
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DOI：
10.1136/jech.2010.118588
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发表时间：
2011-10-01
影响因子：
6.3
通讯作者：
Rodgers, Anthony
中科院分区：
文献类型：
--
作者：
Blakely, Tony;Mhurchu, Cliona Ni;Rodgers, Anthony
减少健康不平等需要在弱势群体中同样有效的干预措施，如果不是更好的话。本研究的目的是确定价格折扣和定制的营养教育对超市食品购买的影响（从购买的饱和脂肪和健康食品中获得的能量百分比）因种族而异，方法一项2 × 2析因试验，1104名新西兰购物者随机接受12.5%的健康食品折扣和/或定制的营养教育，结果价格折扣或营养教育与饱和脂肪能量百分比或营养教育与健康食品购买没有总体关联。价格折扣与健康食品购买有联系（0.79 kg/周增加; 95% CI 0.43 - 1.16），因种族而异（p=0.04）：欧洲/其他1.02 kg/周（n=755; 95% CI 0.60至1.43）;太平洋1.20 kg/周（n=101; 95% CI 0.06至2.34）;毛利-0.15 kg/周（n=248; 95% CI -1.10至0.80）。这种关联的价格折扣与健康的食品采购没有不同的家庭收入或education.Conclusions虽然一个统计学上的显着变化，种族的影响，价格折扣对食品采购，作者警告对因果关系的解释，由于可能的偏见（如，磨损），差异影响毛利人和太平洋人。该研究强调了社会团体为公共卫生干预措施提供有效证据的挑战。针对所有社会群体开展有针对性的营养教育的研究结果表明，结构性干预措施（如价格）可能更有效。
Background Reducing health inequalities requires interventions that work as well, if not better, among disadvantaged populations. The aim of this study was to determine if the effects of price discounts and tailored nutrition education on supermarket food purchases (percentage energy from saturated fat and healthy foods purchased) vary by ethnicity, household income and education.Method A 2X2 factorial trial of 1104 New Zealand shoppers randomised to receive a 12.5% discount on healthier foods and/or tailored nutrition education (or no intervention) for 6 months.Results There was no overall association of price discounts or nutrition education with percentage energy from saturated fat, or nutrition education with healthy food purchasing. There was an association of price discounts with healthy food purchasing (0.79 kg/week increase; 95% CI 0.43 to 1.16) that varied by ethnicity (p=0.04): European/other 1.02 kg/week (n=755; 95% CI 0.60 to 1.43); Pacific 1.20 kg/week (n=101; 95% CI 0.06 to 2.34); Maori -0.15 kg/week (n=248; 95% CI -1.10 to 0.80). This association of price discounts with healthy food purchasing did not vary by household income or education.Conclusions While a statistically significant variation by ethnicity in the effect of price discounts on food purchasing was found, the authors caution against a causal interpretation due to likely biases (eg, attrition) that differentially affected Maori and Pacific people. The study highlights the challenges in generating valid evidence by social groups for public health interventions. The null findings for tailored nutritional education across all social groups suggest that structural interventions (such as price) may be more effective.