A randomized trial of web-based behavioral economic interventions to promote healthy food choices among food pantry clients

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PROJECT SUMMARY Obesity, unhealthy dietary habits, and food insecurity are major public health concerns, especially affecting individuals living in poverty. Food pantries, which provide free food to those in need, are increasingly interested in promoting healthy choices, but few rigorous studies have tested low-cost, behavioral interventions to encourage healthy food choices in food pantry settings. The overall objective of this proposal is to conduct a 1-year randomized-controlled trial among 500 regular food pantry clients to compare the influence of a behavioral economic intervention to promote healthier food choices delivered via a web-based ordering platform to usual care (control group). At this pantry, clients are assigned points to “buy” food and place their orders via a touchscreen-based computer ordering platform. We will implement an intervention that employs several behavioral economic strategies and compare this intervention to the food pantry’s current online ordering system (usual care control group). Our behavioral economic intervention uses the following four strategies to promote healthier choices: 1) default settings; 2) healthy placement choice architecture; 3) simple and salient nutrition messaging; and 4) social norms messaging. Food pantry clients assigned to the intervention group will log into the usual food ordering platform, but it will pre-populate their shopping basket with several healthy, preferred items as the default (clients can opt to remove them). In addition, as clients navigate the website, a healthy placement choice architecture intervention will place the healthiest options at the top of the webpage for each food category. The third intervention component will display simple and salient traffic light labels to indicate foods that are more and less healthy along with salient messaging to highlight price discounts on healthier foods (e.g., “save 1.5 points by switching from white to brown rice”). The fourth intervention will display social norms messaging indicating the most commonly selected healthy products (e.g., over half of all customers order bananas when shopping here). We will compare how these two interventions influence: 1) the nutritional quality of food selected from the pantry based on transaction data; 2) dietary intake measured by fruit and vegetable biomarkers and food frequency questionnaires; and 3) objectively measured weight, blood pressure, and HbA1c levels. !