Are Dutch adults equally susceptible to nudging and pricing strategies? Secondary analyses of the Supreme Nudge parallel cluster-randomised controlled supermarket trial

• Published in: BMC medicine 2024-06, Vol.22 (1), p.228-11
• Main Authors: Stuber, Josine M, Beulens, Joline W J, van Lierop, Juul J E, Schuurman, Esmee, Lakerveld, Jeroen, Mackenbach, Joreintje D
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Aged, 80 and over; Analysis; Choice architecture; Chronic illnesses; Clinical trials; Clusters; Commerce; Costs and Cost Analysis; Data collection; Decision making; Diet; Diet, Healthy - economics; Female; Food; Food environment; Food habits; Grocery store; Health aspects; Health promotion; Health Promotion - methods; Humans; Impulsivity; Intervention; Male; Management; Marketing research; Middle Aged; Netherlands; Prevention; Pricing; Public Health Nutrition; Shopping; Statistical analysis; Subgroups; Supermarkets; Type 2 diabetes
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-024-03429-5

Supermarket interventions are promising to promote healthier dietary patterns, but not all individuals may be equally susceptible. We explored whether the effectiveness of nudging and pricing strategies on diet quality differs by psychological and grocery shopping characteristics. We used data of the 12-month Supreme Nudge parallel cluster-randomised controlled supermarket trial, testing nudging and pricing strategies to promote healthier diets. Participants were Dutch speaking adults aged 30-80 years and regular shoppers of participating supermarkets (n = 12) in socially disadvantaged neighbourhoods. Data on psychological characteristics (food-related behaviours; price sensitivity; food decision styles; social cognitive factors; self-control) and grocery shopping characteristics (time spent in the supermarket; moment of the day; average supermarket visits; shopping at other retailers; supermarket proximity) were self-reported at baseline. These characteristics were tested for their moderating effects of the intervention on diet quality (scored 0-150) in linear mixed models. We included 162 participants from intervention supermarkets and 199 from control supermarkets (73% female, 58 (± 10.8) years old, 42% highly educated). The interventions had no overall effect on diet quality. Only five out of 23 potential moderators were statistically significant. Yet, stratified analyses of these significant moderators showed no significant effects on diet quality for one of the subgroups and statistically non-significant negative effects for the other. Negative effects were suggested for individuals with lower baseline levels of meal planning (β - 2.6, 95% CI - 5.9; 0.8), healthy shopping convenience (β - 3.0, 95% CI - 7.2; 1.3), and healthy food attractiveness (β - 3.5, 95% CI - 8.3; 1.3), and with higher levels of price consciousness (β - 2.6, 95% CI - 6.2; 1.0) and weekly supermarket visits (β - 2.4, 95% CI - 6.8; 1.9). Adults with varying psychological and grocery shopping characteristics largely seem equally (un)susceptible to nudging and pricing strategies. It might be that certain characteristics lead to adverse effects, but this is not plausible, and the observed negative effects were small and statistically non-significant and may be explained by chance findings. Verification of these findings is needed in real-world trials based on larger sample sizes and with the use of more comprehensive interventions. Dutch Trial Register ID NL7064, 30th of May, 2018, ht