Abstract MP39: Peer Comparison Feedback and Financial Incentives to Promote Employees’ Healthy Food Choices: a Randomized Controlled Trial

Objective: New strategies are needed to promote healthy food choices. We conducted a 3-arm randomized controlled trial to compare the effectiveness of: 1) peer comparison feedback about food purchases (FB), 2) feedback plus financial incentives (FB+INC), or 3) no feedback (control) to promote healthy purchases by employees in a large hospital cafeteria. Methods: Subjects were 2672 employees who made ≥ 6 purchases in 2 months prior to study. All items were labeled green (healthy), yellow (less healthy), and red (unhealthy). The FB group received monthly letters from Oct-Dec 2012 reporting proportion of the individual’s purchases that were green/yellow/red in the prior month, comparing to purchases by “all” and by “healthiest” employees. The FB+INC group received a similar letter plus an incentive ($10) to increase their proportion of green in the next month. Control received no contact. We compared changes in green and red purchases from baseline (Sept) to intervention end (Dec) and to end of a 3 month wash-out (Mar 2013) using random effects models of employee-specific changes in purchases. Results: Subjects were: 73% female; 48% > 40 years; 75% white. At baseline, mean proportion of green purchases was 50% for all groups. The Figure shows monthly percentage change in proportion of green purchases compared to baseline. At end of intervention compared to baseline, control had no change, FB increased 1.8% (p=0.07 vs. control), and FB+INC increased 2.2% (p=0.03 vs. control). At end of wash-out compared to baseline, control increased 1.7%, FB increased 2.6% (p=0.4 vs. control), and FB+INC increased 3.0% (p=0.2 vs. control). Red purchases decreased in both intervention groups compared to control at end of intervention (p=0.07 for both) and wash-out (p≤0.04 for both). Conclusions: Providing peer comparison feedback with small financial incentives increased healthy purchases by employees. This population-based approach for promoting healthy eating could be effective in other worksite, institutional, and retail settings.

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Social norms and financial incentives to promote employees' healthy food choices: A randomized controlled trial

Preventive Medicine ◽

10.1016/j.ypmed.2016.01.017 ◽

2016 ◽

Vol 86 ◽

pp. 12-18 ◽

Cited By ~ 20

Author(s):

Anne N. Thorndike ◽

Jason Riis ◽

Douglas E. Levy

Keyword(s):

Randomized Controlled Trial ◽

Social Norms ◽

Financial Incentives ◽

Controlled Trial ◽

Food Choices ◽

Healthy Food ◽

Randomized Controlled

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Abstract MP07: Automated, Personalized Feedback and Behavioral Nudges to Improve Workplace Food Choices and Prevent Weight Gain: Choosewell 365 Randomized Controlled Trial

Circulation ◽

10.1161/circ.141.suppl_1.mp07 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Anne N Thorndike ◽

Jessica L McCurley ◽

Emily D Gelsomin ◽

Eric B Rimm ◽

Yuchiao Chang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Weight Gain ◽

Health Outcomes ◽

Controlled Trial ◽

Intervention Group ◽

Food Choices ◽

Healthy Food ◽

Traffic Light ◽

Randomized Controlled ◽

Prevent Weight Gain

Importance: Workplace health promotion programs often have limited reach and effectiveness because they are time-intensive and not integrated with the work environment. Objective: Conduct a randomized controlled trial testing an automated intervention combined with workplace cafeteria traffic-light labels to prevent weight gain and increase healthy food choices. Methods: 602 hospital employees who regularly used 6 on-site cafeterias and paid with their ID were randomized in 2016-18. Cafeteria labels identified healthy (green), less healthy (yellow), and unhealthy (red) items. Participants completed visits, surveys, and dietary recalls at baseline and 12 months (end of intervention). The intervention group received personalized emails (2/week) and letters (1/month) that were automatically generated by a software platform that integrated cafeteria sales, health, and survey data. Emails included a log of weekly purchases (item, traffic light label, and calories) and health tips. Letters included social norm comparisons and small incentives for healthy purchases. The control group received standard lifestyle advice in monthly letters. A Healthy Purchasing Score was calculated by weighting purchased items by traffic light labels (red=0; yellow=0.5; green=1) using 12 mo of purchases during both baseline (pre-intervention) and intervention. Differences in differences in health outcomes, purchases, and dietary quality were compared, with missing values imputed. Results: Participants were 43.6 years (mean), 79% female, and 81% white. The intervention group increased healthy purchases compared to control, but changes in BMI and health outcomes were not different (see Table). Conclusion: An automated intervention linked to the workplace food environment increased healthy food choices but did not prevent weight gain. To improve health, this scalable healthy eating intervention could be augmented with additional technology to improve other health behaviors, such as physical activity, both at work and home.

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