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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether a new, behavior-focused online system (a behavioral economics-enhanced user interface) can help food agencies select healthier options. The system ranks food by healthiness, displaying the healthiest choices first to encourage better decisions. The goal is to determine if this approach leads to more nutritious selections by agencies using a food bank's ordering platform. Food agencies ordering from the Greater Boston Food Bank online platform qualify for this trial if they place an order within two months of the study's start. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance community health through better food choices.

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 prior data suggests that this behavioral economics-enhanced user interface is safe for promoting healthy eating?

Research shows that strategies from behavioral economics can help people make healthier food choices. Studies have found that organizing foods by health ratings can lead to better selections in places like food pantries. These strategies focus on changing how choices are presented, ensuring safety. No reports of negative effects exist because the approach involves rearranging food displays, not altering the food itself or its consumption. This makes it easy for participants to accept. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a novel way to promote healthier eating through a behavioral economics-enhanced user interface. Unlike the standard food ordering systems that list items alphabetically, this interface prioritizes healthier choices by displaying green-labeled foods first, encouraging users to select nutritious options more easily. This approach leverages subtle cues and information, like showing the percentage of healthy items ordered by top-performing food pantries, to potentially nudge users toward better dietary decisions. By tapping into behavioral economics, this method aims to subtly influence choices without limiting freedom, making it an intriguing alternative to traditional nutritional education or restriction-based approaches.

What evidence suggests that the behavioral economics-enhanced user interface is effective for promoting healthy food choices?

Research shows that strategies from behavioral economics can help people make healthier eating choices. In this trial, participants will experience different user interfaces. One group will use a behavioral economics-enhanced interface, where a traffic light system—green for healthy, yellow for moderate, and red for less healthy—guides healthier choices. Another group will use the usual interface, where foods are listed alphabetically by default. Previous studies have found that similar strategies in nutrition apps have helped people, especially those with chronic diseases, make better health choices. This method uses simple signals and social influence to gently encourage better food decisions. Overall, these tools have shown promise in promoting healthier eating habits by subtly changing how choices are presented. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0749379714004541

Use of Psychology and Behavioral Economics to Promote ... This paper focuses on a handful of behavioral science insights that help explain why it is difficult to eat healthfully in the current food environment.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9883741/

Behavior Change Effectiveness Using Nutrition Apps in ... The results suggest that mHealth apps involving nutrition can significantly improve health outcomes in people with chronic diseases.

3. jamanetwork.com jamanetwork.com/journals/jama-health-forum/fullarticle/2821097

Behavioral Economics to Enhance Food Is Medicine ... We highlight potential applications of behavioral economics in FIM programs, targeting positive effects on referral rates, efficiency and effectiveness of ...

4. improvinghealthcare.mehp.upenn.edu improvinghealthcare.mehp.upenn.edu/thought-leadership/how-behavioral-economics-can-enhance-food-medicine-programs

How Behavioral Economics Can Enhance Food Is Medicine ... There, he guides students through the potential of defaults, incentives, and social pressure to spark better decisions about healthy eating, ...

5. ers.usda.gov ers.usda.gov/sites/default/files/_laserfiche/publications/46106/11201_err68.pdf?v=61948

Behavioral Economic Concepts To Encourage Healthy ... To gauge the efficacy of behavioral economic tools in shaping food choices and eating environments, this report summarizes the results of a behavioral.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7829055/

A behavioural economics approach to improving healthy ... To test the effect of a behavioural economics intervention in two food pantries on the nutritional quality of foods available at the pantries and the foods ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9733085/

Digital health interventions to improve eating behaviour of ... The aim of this scoping review is to identify the BCTs that are used in diet-related digital interventions targeted at people with a low SEP.

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0950329317303099

Using insights from behavioral economics to nudge ... This study investigates how nudging can be used to design menus that guide consumers to make healthier choices.

9. link.springer.com link.springer.com/rwe/10.1007/978-3-319-75388-1_202-1

Behavioral Economics to Understand Sustainable and ... In the context of food, temporal discounting can influence dietary behaviors such as choosing unhealthy or indulgent foods in the present moment ...