title: Improving Healthy Eating and the Bottom Line: Impact of a Price Incentive Program in 2 Hospital Cafeterias.
abstract: To evaluate the impact of a health-promoting price intervention on food sales and profit.
  
  
  
  Nonrandomized evaluation study.
  
  
  
  Two hospital cafeterias.
  
  
  
  Hospital employees (2800) were the priority population.
  
  
  
  During baseline phase, healthy versions of existing unhealthy items were introduced. The intervention phase included marketing and price incentives/disincentives for healthy and unhealthy items, with a 35% price differential.
  
  
  
  Average and proportional change in sales and impact on financial outcomes were assessed.
  
  
  
  Two-way factorial analyses of variance and two-proportion Z-score tests were run to assess change in sales. Independent samples t tests were used to test for changes in profit.
  
  
  
  Significant impact was demonstrated on all burger sales in the desired direction during intervention (P < .001). Most notably, the average weekly turkey burger sales at Penrose Hospital (PH) increased 13-fold (10.85-145.59) and became the majority of the market share (51.8%, P < .001). For salads, significant interaction between phase and food type was found at St. Francis Medical Center (SFMC) (P = .002) but not at PH (P = .304). Healthy PH salads were popular at baseline and intervention, comprising the majority of the market share throughout the entire study (68.4%-70.2%, respectively, P = .238). Cafeteria gross sales and burger profit (P < .001) increased at both cafeterias.
  
  
  
  Incentivizing consumers through price interventions changed hospital cafeteria food sales in the desired direction while improving the bottom line.
authors.affiliation: Public Health Partners, LLC, Englewood, CO, USA amy@publichealth-partners.com.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Patsch
authors.affiliation: Applied Research Solutions, Inc, Colorado Springs, CO, USA.
authors.forename: Jennifer Howard
authors.initials: JH
authors.lastname: Smith
authors.affiliation: YMCA of the Pikes Peak Region, Colorado Springs, CO, USA.
authors.forename: Mina L
authors.initials: ML
authors.lastname: Liebert
authors.affiliation: Northern Arizona University, Flagstaff, AZ, USA.
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Behrens
authors.affiliation: Penrose Hospital, Colorado Springs, CO, USA.
authors.forename: Tami
authors.initials: T
authors.lastname: Charles
mesh_terms: D000072001:Diet, Healthy / Q000191:economics*; D002149:Energy Intake; D005521:Food Service, Hospital / Q000191:economics / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D009042:Motivation; D017132:Workplace
keywords: commerce; food; intervention studies; nutrition policy