scholarly journals Use of financial incentives and text message feedback to increase healthy food purchases in a grocery store cash back program: a randomized controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anjali Gopalan ◽  
Pamela A. Shaw ◽  
Raymond Lim ◽  
Jithen Paramanund ◽  
Deepak Patel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Financial Incentives ◽  
Controlled Trial ◽  
Text Message ◽  
Healthy Food ◽  
Grocery Store ◽  
Randomized Controlled ◽  
Food Purchases

scholarly journals A Randomized Controlled Trial Testing the Effects of Singapore’s Front-of-Pack Healthier Choice Symbol Label With or Without a Physical Activity Equivalent Label on Food Purchases and Measures of Diet Quality

2019 ◽  
Author(s):  
Eric Finkelstein ◽  
Brett Doble ◽  
Felicia Jia Ler Ang ◽  
Wei Han Melvin Wong ◽  
Rob M. van Dam
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Diet Quality ◽  
Controlled Trial ◽  
Caloric Intake ◽  
Random Order ◽  
Grocery Store ◽  
Food Category ◽  
Randomized Controlled ◽  
Food Purchases

Abstract Background Singapore’s front-of-pack (FOP) Healthier Choice Symbol (HCS) label is an easy to understand signal to consumers of how they can make a healthier choice within a given food category. We assess its effectiveness at influencing food purchases and diet quality.Methods Randomized controlled trial using a 3×3 within-subject crossover design with adult Singapore residents recruited online. Each participant shopped once in three conditions on an experimental online grocery store in random order: 1) no FOP control; 2) Similar to Arm 1 except select products displayed HCSs, as would occur in stores in Singapore; 3) Similar to Arm 2 with additional information displaying Physical Activity Equivalents (PAEs) per serving of each product. Participants with minimum of one control and one intervention condition shop were analyzed. First-differenced regressions on calories per serving (primary) and other measures of diet quality were used to compare purchasing behavior across conditions. Results From January 2019 to April 2019, 117 participants were randomized: 10 (8·5%) completed one shop; 2 completed two shops (1.7%); and 105 (89·7%) completed all three, resulting in 317 unique shops. The HCS, without PAEs, led to a statistically significant five-percentage point increase in the proportion of HCS products purchased. However, we could not reject the null hypothesis of no difference in calories per serving in either HCS (95% CI, -10·63: 20·01) or when combined with PAEs (95% CI, -5·25: 21·54) or differences in any of the diet quality measures assessed.Conclusions The HCS influences purchasing patterns, but does not, either alone or in combination with a PAE label, appear to reduce caloric intake or improve overall diet quality. These findings suggest that the HCS label, as currently applied, may be the wrong label for addressing rising rates of obesity and non-communicable diseases in Singapore.

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

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Anne N Thorndike ◽  
Jason Riis ◽  
Douglas E Levy
Keyword(s):  
Randomized Controlled Trial ◽  
Financial Incentives ◽  
Controlled Trial ◽  
Food Choices ◽  
Population Based ◽  
Healthy Food ◽  
Large Hospital ◽  
Random Effects Models ◽  
Randomized Controlled ◽  
Similar Letter

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.

Efficacy and Impact of an mHealth Intervention to promote Mental Wellness for American Indian and Alaska Native Teens and Young Adults: A Randomized Controlled Trial of the BRAVE Study (Preprint)

2020 ◽  
Author(s):  
Stephanie Craig Rushing ◽  
Allyson Kelley ◽  
Sheana Bull ◽  
David Stephens ◽  
Julia Wrobel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Young Adults ◽  
Alaska Native ◽  
Help Seeking ◽  
Culturally Relevant ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Randomized Controlled ◽  
Mental Wellness

BACKGROUND Culturally-relevant interventions are needed to help American Indian and Alaska Native (AI/AN) teens and young adults navigate common risky situations involving family and friends, including drug and alcohol misuse, dating violence, and suicidality. We R Native – a multimedia health resource for Native teens and young adults – designed an intervention for Native youth, delivered via text message, that includes role model videos, mental wellness strategies, and links to culturally-relevant resources (hotlines, chat-lines, websites, etc.) and social support. OBJECTIVE This study aims to test the efficacy of BRAVE to improve participant’s physical, mental, and spiritual health, their use of mental wellness strategies, their help-seeking skills, and associated factors, including cultural resilience, identity, and cultural pride. METHODS The randomized controlled trial was carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2,334 AI/AN teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1,044 to participate. AI/AN teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and cultural resilience; or 8 weeks of STEM text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine (STEM); and then received the other set of messages. Primary and secondary outcomes were tested using linear mixed-effect models and linear regressions. RESULTS A total of 833 AI/AN teens and young adults were included in the analysis. Individuals in the BRAVE and STEM arms showed significant positive trends over the course of the study for all primary outcomes except cultural identity and help seeking behavior. Mean scores were significantly different for health (P<.001), resilience (P<.001), negative coping (P=.027), positive coping (P<.001), self-efficacy (P=.021), and self-esteem (P<.001). Changes in help-seeking self-efficacy were significant for those exhibiting risky behavior at baseline to exit (P=.01). Those who reported positive coping scores at baseline also reported better health on average, but no difference in risky drug and alcohol use (P<.001). The number of participants that used text messages to help themselves increased from 69% at 3-months (427/618) to 75% at 8-months (381/501) (P<.001). Similarly, the number of participants that used text messages to help a friend or family member increased from 22% at 3-months (138/616) to 55% at 8-months (272/498). CONCLUSIONS This is the first nationwide randomized controlled trial for AI/AN teens and young adults to test the efficacy of an mHealth intervention on mental wellness. The findings suggest that culturally-relevant multimedia, mHealth interventions can improve help-seeking behavior. Lessons learned from this study may help other AI/AN-serving organizations, prevention programs, policymakers, researchers, and educators as they support the next generation of AI/AN change-makers.

scholarly journals Effect of automated messaging on oral hygiene in adolescent orthodontic patients: A randomized controlled trial

2018 ◽  
Vol 89 (2) ◽  
pp. 262-267 ◽  
Author(s):  
Mike C. Ross ◽  
Phillip M. Campbell ◽  
Larry P. Tadlock ◽  
Reginald W. Taylor ◽  
Peter H. Buschang
Keyword(s):  
Randomized Controlled Trial ◽  
Oral Hygiene ◽  
Treatment Time ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Orthodontic Patients ◽  
Hygiene Compliance

ABSTRACTObjective:To determine whether automated text messages sent daily to adolescent orthodontic patients improves oral hygiene more than weekly reminders.Materials and Methods:A blinded, prospective, randomized controlled trial was designed to evaluate the effects of automated messages on oral hygiene. Subjects were recruited from patients undergoing orthodontic treatment at the Texas A&M University College of Dentistry, Department of Orthodontics. They were being treated with a variety of fixed full appliances in both arches. Subjects were randomly assigned to either a once-a-week text message group or a daily text message group. There were 52 females and 27 males who were 12 to 17 years of age. Oral hygiene was measured at the beginning of the study and again 8.6 ± 0.9 weeks later.Results:The daily reminder group (N = 42) had significantly greater improvements in oral hygiene compliance than the weekly reminder group (N = 37). The daily score decreases were 48%, 21% and 19% for the bleeding index (BI), plaque index (PI), and gingival index (GI), respectively. The weekly score decreases were 27%, 14% and 13% for the BI, PI, and GI. There were no sex differences in hygiene changes during the study. The 42% of patients who completed the survey at the end of the study wanted more frequent messages and reported that messages related to decreasing treatment time were the most effective, while those related to oral hygiene were the least effective.Conclusions:Daily text messages are more effective at improving oral hygiene than weekly text messages.

scholarly journals Research and Implementation Lessons Learned From a Youth-Targeted Digital Health Randomized Controlled Trial (the ARMADILLO Study)

10.2196/13005 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e13005
Author(s):  
Lianne Gonsalves ◽  
Winnie Wangari Njeri ◽  
Megan Schroeder ◽  
Jefferson Mwaisaka ◽  
Peter Gichangi
Keyword(s):  
Randomized Controlled Trial ◽  
Digital Health ◽  
Controlled Trial ◽  
Text Message ◽  
Health Interventions ◽  
World Health ◽  
Intervention Period ◽  
Implementation Challenges ◽  
Randomized Controlled ◽  
Client Side

Background Evidence is lacking on the efficacy of sexual and reproductive health (SRH) communication interventions for youth (aged 15-24 years), especially from low- and middle-income countries. Therefore, the World Health Organization initiated the Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) program, a free, menu-based, on-demand text message (SMS, short message service) platform providing validated SRH content developed in collaboration with young people. A randomized controlled trial (RCT) assessing the effect of the ARMADILLO intervention on SRH-related outcomes was implemented in Kwale County, Kenya. Objective This paper describes the implementation challenges related to the RCT, observed during enrollment and the intervention period, and their implications for digital health researchers and program implementers. Methods This was an open, three-armed RCT. Following completion of a baseline survey, participants were randomized into the ARMADILLO intervention (arm 1), a once-a-week contact SMS text message (arm 2), or usual care (arm 3, no intervention). The intervention period lasted seven weeks, after which participants completed an endline survey. Results Two study team decisions had significant implications for the success of the trial’s enrollment and intervention implementation: a hands-off participant recruitment process and a design flaw in an initial language selection menu. As a result, three weeks after recruitment began, 660 participants had been randomized; however, 107 (53%) participants in arm 1 and 136 (62%) in arm 2 were “stuck” at the language menu. The research team called 231 of these nonengaging participants and successfully reached 136 to learn reasons for nonengagement. Thirty-two phone numbers were found to be either not linked to our participants (a wrong number) or not in their primary possession (a shared phone). Among eligible participants, 30 participants indicated that they had assumed the introductory message was a scam or spam. Twenty-seven participants were confused by some aspect of the system. Eleven were apathetic about engaging. Twenty-four nonengagers experienced some sort of technical issue. All participants eventually started their seven-week study period. Conclusions The ARMADILLO study’s implementation challenges provide several lessons related to both researching and implementing client-side digital health interventions, including (1) have meticulous phone data collection protocols to reduce wrong numbers, (2) train participants on the digital intervention in efficacy assessments, and (3) recognize that client-side digital health interventions have analog discontinuation challenges. Implementation lessons were (1) determine whether an intervention requires phone ownership or phone access, (2) digital health campaigns need to establish a credible presence in a busy digital space, and (3) interest in a service can be sporadic or fleeting. Clinical Trial International Standard Randomized Controlled Trial Number (ISRCTN): 85156148; http://www.isrctn. com/ISRCTN85156148

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