Behavioral Economics for Healthy Eating

Overseen By Douglas Levy, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Non-GBFB users

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

364 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this randomized controlled trial is to test whether using behavioral economic strategies to promote healthy food choices on a food bank's online ordering platform increases the use of the traffic light nutrition ranking system and increases healthier food selections by the food agencies (e.g., food pantries) who use the food bank.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Behavioral economics-enhanced user interface for healthy eating?

Research shows that behavioral economics can help improve healthy food choices by using strategies that align with how people naturally make decisions. For example, interventions in food pantries and hospital cafeterias have successfully increased the selection of healthier foods by making them more accessible and appealing. ^{1 2 3 4 5}

Is the use of behavioral economics for healthy eating safe for humans?

The research does not provide specific safety data for using behavioral economics in healthy eating interventions, but these strategies generally involve non-invasive methods like nudging and financial incentives, which are considered safe for humans. ^{1 3 6 7 8}

How does the treatment Behavioral economics-enhanced user interface differ from other treatments for healthy eating?

This treatment is unique because it uses principles of behavioral economics to make healthy eating choices easier and more appealing, rather than relying solely on education or traditional economic incentives. It focuses on modifying the environment and decision-making processes to align with natural human behavior patterns, helping people make healthier choices without requiring significant changes in their habits. ^{5 6 9 10 11}

Eligibility Criteria

This trial is for food agencies that order supplies from the Greater Boston Food Bank's online platform. It aims to see if these agencies will choose healthier foods when a special ranking system is used.

Inclusion Criteria

Food agencies that order food from the Greater Boston Food Bank (GBFB) online ordering platform.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Agencies use the behavioral economics-enhanced user interface to order food with traffic light nutrition ranking

12 months

Ongoing online interactions

Survey and Adaptation

Agency staff complete a survey about their online ordering experiences, and the SWAP-enhanced interface is updated and implemented for all agencies

1-2 months

Follow-up

Agency ordering outcomes are monitored for an additional period to assess long-term effects

12 months

Treatment Details

Interventions

• Behavioral economics-enhanced user interface

Trial Overview The study tests a behavioral economics-enhanced user interface on GBFB's ordering platform. The idea is to see if this approach helps agencies pick more nutritious options using a 'traffic light' nutrition ranking.

Participant Groups

Group I: Behavioral economics-enhanced user interface Experimental Treatment 1 Intervention

Food agencies will see the behavioral economics (BE)-enhanced interface by default; food items will be sorted with green-labeled items listed first, followed by yellow, then red. If users search for a specific item type (e.g., chicken) the results returned for that item type will also be sorted so that green-labeled items are listed first. At any time during the ordering episode, users will have the option to switch from the BE-enhanced default to an alternate sorting or filtering choice, such as alphabetical or cost. Users will be shown the percent of items (by weight) that are labeled green in a prominent location on the ordering screen. The percent green-labeled items in the order will appear alongside messaging reporting the average percent green-labeled items ordered by GBFB pantries that rank in the top 10% based on this metric.

Group II: Usual user interface Active Control 1 Intervention

When agency staff log on to the food bank platform, by default, foods are listed in alphabetical order. If they wish, users can change how items are sorted or filtered using pull-down menus and check-boxes, including the ability to have items sorted or filtered based on traffic light labels. As orders are created, an information section at the top of the page is updated with details on the order weight and cost.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Findings from Research

Financial incentives based on behavioral economics significantly increased the odds of health behavior change, with participants having nearly four times higher odds of changing their behavior compared to those in the control group (odds ratio of 3.96).

The effectiveness of these financial incentives did not vary significantly by demographic factors such as gender, age, or education, but showed that Black participants had higher odds of behavior change compared to White participants when using conditional payments, while higher-income individuals had lower odds of change with a specific incentive structure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of behavioral economic incentive design and demographic characteristics in financial incentive-based approaches to changing health behaviors: a meta-analysis. Haff, N., Patel, MS., Lim, R., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Special issue: Behavioral Economics and Health Annual Symposium. [2011]

2. England pubmed.ncbi.nlm.nih.gov

A behavioural economics approach to improving healthy food selection among food pantry clients. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices. [2021]

4. New Zealand pubmed.ncbi.nlm.nih.gov

Helping patients make better decisions: how to apply behavioral economics in clinical practice. [2020]

5. England pubmed.ncbi.nlm.nih.gov

Make the healthy choice the easy choice: using behavioral economics to advance a culture of health. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

The role of behavioral economic incentive design and demographic characteristics in financial incentive-based approaches to changing health behaviors: a meta-analysis. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Nudging food service users to choose fruit- and vegetable-rich items: Five field studies. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Examining the feasibility of implementing behavioural economics strategies that encourage home dinner vegetable intake among low-income children. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Effects of a Behavioral Economics Intervention on Food Choice and Food Consumption in Middle-School and High-School Cafeterias. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Testing the effectiveness of in-home behavioral economics strategies to increase vegetable intake, liking, and variety among children residing in households that receive food assistance. [2016]

11. United States pubmed.ncbi.nlm.nih.gov

Behavioral Economic Factors Related to Pediatric Obesity. [2022]