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Open Access Highly Accessed Research

Choosing healthier foods in recreational sports settings: a mixed methods investigation of the impact of nudging and an economic incentive

Dana Lee Olstad123*, Laksiri A Goonewardene24, Linda J McCargar12 and Kim D Raine13

Author Affiliations

1 Alberta Institute for Human Nutrition, 2-021D Li Ka Shing Centre, University of Alberta, Edmonton, AB T6G 2E1, Canada

2 Department of Agricultural, Food and Nutritional Science, 4–10 Agriculture/Forestry Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada

3 Centre for Health Promotion Studies, University of Alberta, 3-300 ECHA, 11405 87 Ave, Edmonton, AB T6G 1C9, Canada

4 Alberta Agriculture and Rural Development, Government of Alberta, #307, 7000 113 Street, J.G. O’Donoghue Building, Edmonton, AB T6H 5T6, Canada

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International Journal of Behavioral Nutrition and Physical Activity 2014, 11:6  doi:10.1186/1479-5868-11-6

Published: 22 January 2014

Abstract

Background

Nudging is an approach to environmental change that alters social and physical environments to shift behaviors in positive, self-interested directions. Evidence indicates that eating is largely an automatic behavior governed by environmental cues, suggesting that it might be possible to nudge healthier dietary behaviors. This study assessed the comparative and additive efficacy of two nudges and an economic incentive in supporting healthy food purchases by patrons at a recreational swimming pool.

Methods

An initial pre-intervention period was followed by three successive and additive interventions that promoted sales of healthy items through: signage, taste testing, and 30% price reductions; concluding with a return to baseline conditions. Each period was 8 days in length. The primary outcome was the change in the proportion of healthy items sold in the intervention periods relative to pre- and post-intervention in the full sample, and in a subsample of patrons whose purchases were directly observed. Secondary outcomes included change in the caloric value of purchases, change in revenues and gross profits, and qualitative process observations. Data were analyzed using analysis of covariance, chi-square tests and thematic content analysis.

Results

Healthy items represented 41% of sales and were significantly lower than sales of unhealthy items (p < 0.0001). In the full sample, sales of healthy items did not differ across periods, whereas in the subsample, sales of healthy items increased by 30% when a signage + taste testing intervention was implemented (p < 0.01). This increase was maintained when prices of healthy items were reduced by 30%, and when all interventions were removed. When adults were alone they purchased more healthy items compared to when children were present during food purchases (p < 0.001), however parental choices were not substantially better than choices made by children alone.

Conclusions

This study found mixed evidence for the efficacy of nudging in cueing healthier dietary behaviors. Moreover, price reductions appeared ineffectual in this setting. Our findings point to complex, context-specific patterns of effectiveness and suggest that nudging should not supplant the use of other strategies that have proven to promote healthier dietary behaviors.

Keywords:
Environmental change; Intervention; Nudge; Economic incentive; Healthy food; Dietary behaviors; Community context; Profit; Behavioral economics; Mixed methods