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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 : Completed
First Posted : November 20, 2018
Last Update Posted : October 1, 2021
Sponsor:
Information provided by (Responsible Party):
University of Rhode Island

Tracking Information
First Submitted Date  ICMJE July 18, 2018
First Posted Date  ICMJE November 20, 2018
Last Update Posted Date October 1, 2021
Actual Study Start Date  ICMJE September 10, 2018
Actual Primary Completion Date May 1, 2019   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: November 16, 2018)
  • 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.
  • 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
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: November 16, 2018)
  • 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
  • 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.
  • 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)
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures
 (submitted: November 16, 2018)
  • 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
  • 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.
  • 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.
  • 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.
  • 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.
Original Other Pre-specified Outcome Measures Same as current
 
Descriptive Information
Brief Title  ICMJE Targeted Food Incentives to Improve Diet Quality and Health Among Adults
Official Title  ICMJE Individually-targeted Incentives, Diet Quality, and Health Outcomes Among Adults
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.
Detailed Description A detailed description of Eligibility and outcome measures is entered elsewhere
Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Participant)
Primary Purpose: Prevention
Condition  ICMJE
  • Diet Modification
  • Diet Habit
Intervention  ICMJE
  • 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.
Study Arms  ICMJE
  • 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
    Interventions:
    • Behavioral: Targeted incentives
    • Behavioral: Nominal loyalty card discount and nutrition education
  • 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.
    Intervention: Behavioral: Nominal loyalty card discount and nutrition education
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: September 30, 2021)
224
Original Estimated Enrollment  ICMJE
 (submitted: November 16, 2018)
225
Actual Study Completion Date  ICMJE May 1, 2019
Actual Primary Completion Date May 1, 2019   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

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
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03748056
Other Study ID Numbers  ICMJE 1240194-3
AWD05956 , Project 0006418 ( Other Grant/Funding Number: Foundation for Food and Agricultural Research )
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party University of Rhode Island
Study Sponsor  ICMJE University of Rhode Island
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Maya Vadiveloo University of Rhode Island
PRS Account University of Rhode Island
Verification Date September 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP