Behavioral Economics for Healthy Eating

(BeWell Trial)

Overseen By Anne N Thorndike, MD, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Non-English/Spanish speakers, others

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

Compensation: Varies

Number of Visits: Unknown

3750 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to determine if behavioral economics tools can help food pantries encourage healthier food choices through a program called SWAP. This program uses a traffic light system to label foods as red, yellow, or green based on their healthiness. Pantries in the trial will be divided into two groups: one using behavioral economics-enhanced strategies, such as incentives and learning communities, and the other receiving basic support. This trial suits food pantries affiliated with the Greater Boston Food Bank, offering maximum client choice, and not currently using a traffic-light nutrition ranking.

As an unphased trial, this study provides a unique opportunity to contribute to innovative strategies for promoting healthier eating habits in communities.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these behavioral economics tools are safe for promoting healthy eating?

Research has shown that simple strategies to encourage healthier eating are generally safe. These methods make healthy foods more appealing and increase their variety in diets. Studies have found that these techniques help people make better food choices without causing harm.

The SWAP program employs these strategies and has been tested before. It guides people to choose healthier foods through labels and rewards. No reports of negative effects have emerged from these kinds of programs.

In summary, these tools to promote healthy eating are well-tolerated. The program aims to help people choose healthier foods without any known risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Behavioral Economics for Healthy Eating trial because it explores innovative ways to encourage healthier food choices in food pantries using behavioral nudges. Unlike traditional methods that rely on providing information, this approach uses a color-coded system (red, yellow, green) to help pantry users quickly identify healthier food options. Additionally, the trial offers incentives and resources, like access to a SWAP toolkit and pantry learning communities, to make implementation easier and more engaging. This strategy aims to create a more supportive environment for healthy eating, which could lead to more sustainable dietary changes among pantry users.

What evidence suggests that this trial's treatments could be effective for promoting healthy eating?

This trial will compare two strategies for implementing the SWAP nutrition program in food pantries. Research has shown that certain strategies can help people make healthier food choices. For example, labeling foods with a traffic light system—red, yellow, and green—guides people to choose better options. In this trial, the Behavioral economics-enhanced SWAP implementation strategy will include such labeling, along with other behavioral nudges. Meanwhile, the Basic SWAP implementation strategy will provide pantries with information and encouragement to implement SWAP independently. Other studies have supported that these methods increase both the availability and popularity of healthy foods. By using these strategies, food pantries may notice healthier eating habits in their communities. ^{1 2 4 5 6}

Who Is on the Research Team?

Anne N Thorndike, MD, MPH

Principal Investigator

Massachusetts General Hospital

Are You a Good Fit for This Trial?

This trial is for food pantries within an hour's drive of Boston that partner with the Greater Boston Food Bank, offer maximum client choice, and don't currently use traffic-light nutrition rankings. Clients participating in assessments must be adults who speak English or Spanish.

Inclusion Criteria

Food pantries enrolled in the study must be partner agencies of the Greater Boston Food Bank that are maximum client choice, located within approximately 1 hour driving time of Boston, and not actively using traffic-light nutrition ranking

Exclusion Criteria

Food pantries that are not affiliated with the Greater Boston Food Bank and are not maximum client choice

I use a food pantry and do not speak English or Spanish.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

Pantries implement the SWAP program using behavioral economics tools or basic strategies

12 months

Ongoing monitoring and support visits

Follow-up

Participants are monitored for the effectiveness of the SWAP program implementation

6 months

Adaptation and Extension

BE-enhanced SWAP strategy is adapted and offered to control group pantries

Post-12 months

What Are the Treatments Tested in This Trial?

Interventions

• Basic SWAP implementation
• Behavioral economics-enhanced SWAP implementation

Trial Overview The study compares two ways to implement the SWAP program in food pantries: one enhanced by behavioral economics and a basic version. It aims to see if these methods help correctly apply SWAP's traffic light labels on foods and improve clients' healthy choices over 6 to 12 months.

How Is the Trial Designed?

Group I: Behavioral economics-enhanced SWAP implementation strategy Experimental Treatment 1 Intervention

Pantries assigned to the intervention group will receive behavioral nudges for implementing the SWAP nutrition program. These include: 1) invoice labeling with the food labeled as red, yellow, or green; 2) receipt of the SWAP toolkit at no cost; 3) pantry learning communities; 4)incentives to purchase SWAP implementation materials (e.g., shelves); 5) food bank recognition for SWAP implementation.

Group II: Basic SWAP implementation strategy Active Control 1 Intervention

Pantries assigned to the control arm will receive email communication from the food bank dietitian providing them with information about SWAP, online links to SWAP implementation guides, and encouragement to purchase SWAP Toolkits on their own.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Published Research Related to This Trial

In a study of 35 randomized controlled trials, financial incentives (FIs) based on behavioral-economic principles, particularly deposit contracts, were found to be the most effective in promoting healthy diet, weight control, and physical activity, significantly increasing goal achievement compared to no incentives.

While both deposit and lottery-based incentives improved physical activity levels during the intervention, only the deposit incentive maintained its effectiveness in the follow-up period, suggesting that behavioral insights can enhance the long-term impact of financial incentives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of the Effectiveness of Behavioral Economic Incentive Programs for Goal Achievement on Healthy Diet, Weight Control and Physical Activity: A Systematic Review and Network Meta-analysis. Boonmanunt, S., Pattanaprateep, O., Ongphiphadhanakul, B., et al.[2023]

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. clinicaltrials.gov clinicaltrials.gov/study/NCT06298253

Behavioral Economics to Implement a Traffic Light Nutrition ... This study will test the use of behavioral economics (BE) tools to encourage food pantries to implement the Supporting Wellness at Pantries (SWAP) program, ...

2. researchgate.net researchgate.net/publication/369712515_The_Implementation_of_a_Nutrition_Intervention_in_Food_Pantries_The_Spirit_of_SWAP

The Implementation of a Nutrition Intervention in Food ... Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy ...

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

A behavioural economics approach to improving healthy ... The intervention aimed to increase the amount and variety of healthy foods (supply), as well as the appeal of healthy foods (demand) using behavioural economics ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S0749379716303397

Behavioral Economics and the Supplemental Nutrition ... This manuscript outlines behavioral economics strategies that have potential to encourage healthier food choices within the SNAP program.

5. annualreviews.org annualreviews.org/content/journals/10.1146/annurev-nutr-111124-101104

Behavioral and Economic Interventions: A Path to ... This narrative review provides a summary and critical discussion of the effectiveness of behavioral and economic interventions in promoting healthier eating

6. academic.oup.com academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuaf183/8285205?searchresult=1

Implementation Determinants of Nutrition Interventions in the ... This scoping review aims to describe the characteristics of nutrition interventions in the charitable food system (CFS), ...