title: Effects of financial incentives for the purchase of healthy groceries on dietary intake and weight outcomes among older adults: A randomized pilot study.
abstract: Providing financial incentives can be a useful behavioral economics strategy for increasing fruit and vegetable intake among consumers. It remains to be determined whether financial incentives can promote intake of other low energy-dense foods and if consumers who are already using promotional tools for their grocery purchases may be especially responsive to receiving incentives. This randomized controlled trial tested the effects of offering financial incentives for the purchase of healthy groceries on 3-month changes in dietary intake, weight outcomes, and the home food environment among older adults. A secondary aim was to compare frequent coupon users (FCU) and non-coupon users (NCU) on weight status, home food environment, and grocery shopping behavior. FCU (n = 28) and NCU (n = 26) were randomly assigned to either an incentive or a control group. Participants in the incentive group received $1 for every healthy food or beverage they purchased. All participants completed 3-day food records and a home food inventory and had their height, weight, and waist circumference measured at baseline and after 3 months. Participants who were responsive to the intervention and received financial incentives significantly increased their daily vegetable intake (P = 0.04). Participants in both groups showed significant improvements in their home food environment (P = 0.0003). No significant changes were observed in daily energy intake or weight-related outcomes across groups (P < 0.12). FCU and NCU did not differ significantly in any anthropometric variables or the level at which their home food environment may be considered 'obesogenic' (P > 0.73). Increased consumption of vegetables did not replace intake of more energy-dense foods. Incentivizing consumers to make healthy food choices while simultaneously reducing less healthy food choices may be important.
authors.affiliation: Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States. Electronic address: tkral@nursing.upenn.edu.
authors.forename: Tanja V E
authors.initials: TV
authors.lastname: Kral
authors.affiliation: University of Massachusetts Medical School, United States.
authors.forename: Annika L
authors.initials: AL
authors.lastname: Bannon
authors.affiliation: Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, United States.
authors.forename: Reneé H
authors.initials: RH
authors.lastname: Moore
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003258:Consumer Behavior / Q000191:economics; D003430:Cross-Sectional Studies; D000072001:Diet, Healthy / Q000191:economics; D004038:Diet, Reducing / Q000191:economics; D058620:Elder Nutritional Physiological Phenomena; D002149:Energy Intake; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D063105:Food Assistance; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D050177:Overweight / Q000178:diet therapy* / Q000191:economics; D010349:Patient Compliance; D015143:Philadelphia; D010865:Pilot Projects; D014675:Vegetables / Q000191:economics
keywords: Diet; Financial incentives; Groceries; Obesity