A Default Option for Health: Improving Nutrition Within the Financial and Geographic Constraints of Food Insecurity

Not Applicable

Completed

• Conditions: Obesity; Food Selection
• Interventions: Behavioral: Default Option; Behavioral: Nutrition Education

• Registration Number: NCT04186533
• Lead Sponsor: University at Albany

Brief Summary

Food insecurity is associated with an increased risk of obesity. The availability of a default option (i.e., option a consumer selects if no active choice is made) has been shown to effectively nudge consumer behavior. An online default option (i.e., prefilled grocery shopping cart) was previously shown to positively impact the food purchases of individuals with food insecurity.The present study aims to extend these findings bye examining efficacy of an online default option in enhancing the nutritional quality of online grocery purchases in individuals with food insecurity over the course of a month.

Detailed Description

Food insecurity is associated with an increased risk of obesity and weight-related illnesses. The present study is the first longitudinal randomized control trial to examine if an online prefilled grocery shopping cart (i.e., a default cart) nudges individuals with food insecurity to purchase healthier groceries compared to receiving nutrition education.

It was hypothesized that the prefilled online grocery shopping cart (i.e., default condition) will result in a significant improvement in the nutritional quality of groceries purchased compared to those receiving nutrition education.

Thirty-eight food pantry users recruited from food pantries in New York in 2018 were enrolled in the present study and were given $48.50 to purchase groceries weekly using an online grocery website for five weeks. At baseline, participants were instructed to purchase groceries keeping in mind nutrition, cost, and taste. For the subsequent four weeks (T1-T4), participants were randomized to receive 1) nutrition education or 2) a prefilled online grocery shopping cart that met their nutritional needs based on age and sex (Default).

Our primary nutritional outcomes included HEI scores, calories (kcal), and energy density (kcal/grams).

Study Timeline

• Study Start: 2018-02-09
• Primary Completion: 2018-05-29
• Study Completion: 2018-06-06
• Status Verified: 2019-12
• Study First Submitted: 2019-12-02
• Study First Submitted QC: 2019-12-02
• Last Update Submitted: 2019-12-02
• Study First Posted: 2019-12-04
• Last Update Posted: 2019-12-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 38

Inclusion Criteria

1. At least 18 years old
2. Residing in a single person household
3. Receiving assistance at a food pantry
4. Able to read and write in English
5. Able to provide informed consent
6. Current residence in a zip code served by Price Chopper's delivery program
7. None of the following dietary restrictions: Vegetarian/vegan, Gluten-free/celiacs, Lactose intolerance, egg allergy

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Default Intervention	Default Option	Participants in the default condition were presented with a pre-filled online shopping cart containing a combination of groceries that meet macro- and micronutrient requirements for their gender and age, and told that they are free to delete, add, and exchange any item they wish to finalize their selections.
Nutrition Education	Nutrition Education	Participants in the nutrition education condition were instructed to read brief nutrition education handouts before online grocery shopping.

Primary Outcome Measures

Name	Time	Method
Energy Density	1 month	kcal/grams
Healthy Eating Index Score	1 month	(score ranging from 0-100
Calories	1 month	kcal

Trial Locations

Locations (1)

University at Albany, SUNY; 🇺🇸 Albany, New York, United States