Evaluation of the Healthy Foods Program

描述（由申请人提供）：改善饮食质量是对抗肥胖的核心组成部分。一个激烈争论的话题是健康食品和营养不良食品价格的作用，但几乎没有数据。国会已要求美国农业部进行一项试点研究，为健康食品提供折扣，但该项目尚未开始，将仅限于马萨诸塞州一个县的选定个人。我们建议分析来自南非健康保险公司Discovery于2009年启动的一个更大的项目的数据。探索的健康食品计划通过一家全国性的连锁超市提供高达25%的健康食品回扣，目前约有20万户家庭参加。有资格享受健康食品优惠折扣的食品是根据国际和美国饮食指南选择的，并在收银机收据和货架上标明。我们将考虑该计划对购买、饮食和健康结果的总体影响，并试图将经济激励的影响与影响整个人口的教育组成部分和环境变化分开。我们的主要统计方法是差异分析（前/后的个人有资格受益于对照组），辅以额外的统计分析，以解决选择偏差。数据来源包括个人健康调查、超市的销售数据（单项和对个人的销售数据）和医疗保健索赔。 公共卫生相关性：该项目将评估一个解决改善饮食和预防肥胖的核心问题的计划：如果健康食品更便宜会怎么样？目前大约有20万户家庭参加了“发现”的健康食品福利计划，该计划为他们购买健康食品提供了大量回扣。通过研究健康食品参与者和对照组的购买行为、自我报告的饮食以及其他健康结果的变化，我们将能够提供关于健康食品的有意义的价格变化在人口水平上可能实现的初步结果。

DESCRIPTION (provided by applicant): Improving diet quality is a central component in the fight against obesity. One hotly debated topic is the role of prices for healthy foods and nutritionally less desirable foods, but little data is available. Congress has asked USDA to conduct a pilot study that provides discounts on healthy foods, but this project has not started yet and will be limited to selected individuals in a single county in Massachusetts. We propose to analyze data from a much larger program that was started in 2009 by the South African health insurance company Discovery. Discovery's HealthyFood program provides rebate of up to 25% on healthy items through a nationwide supermarket chain and presently enrolls about 200,000 households. Food items eligible for a discount on the HealthyFood benefit were selected in agreement with international and US dietary guidelines and are marked on cash register receipts and on the shelves. We will consider the overall impact of the program on purchases, diets, and health outcomes, and also try to separate out the effects of the financial incentives from the educational component and environmental changes that affect the whole population. Our primary statistical approach is difference-in-difference analysis (pre/post of individuals becoming eligible for benefit with control groups), complemented with additional statistical analyses to address selection biases. Data sources include both individual health surveys, sales data from supermarkets (individual line items and linkable to individuals), and health care claims. PUBLIC HEALTH RELEVANCE: This project will evaluate a program that addresses a central issue to improve diet and prevent obesity: What if healthy foods were cheaper? About 200,000 households are currently enrolled in Discovery's HealthyFoodbenefit, a program that gives them a substantial rebate on their healthy food purchases. By studying changes in purchasing behavior, in self-reported diets, and in other health outcomes among HealthyFoodparticipants and a control group, we will be able to provide the first results on what meaningful price changes for healthier foods could achieve at the population level.