Modeling Behavioral Economics Strategies in Social Marketing Messages to Promote Vegetable Consumption to Low-Resource Louisiana Residents: A Conjoint Analysis.

BACKGROUND: Behavioral economics strategies implemented within social marketing campaigns improve eating behavior. OBJECTIVE: To identify which behavioral economics strategies in social marketing messages particularly messengers, norms, and commitments will promote low-income Louisiana residents to add more vegetables to meals. DESIGN: Full profile traditional conjoint analysis survey with single concept ratings. PARTICIPANTS: Purposive sample of low-resource Louisiana residents (N = 213) SETTING: Online survey. INTERVENTION: Participants rated randomized concepts that featured a messenger and a message. MAIN OUTCOME MEASURE: Ratings (one to nine) of likelihood to add vegetables to meals. STATISTICAL ANALYSIS: A model of ratings was generated using mixed-effects multiple regression, which accounted for repeated measurement of participants. Interactions of variables and covariates were modeled. RESULTS: There was a significant main effect of the messenger variable (P = 0.02) and main effect of the message variable (P = 0.008). Pairwise comparisons demonstrated differences between friend (µ (predicted mean) = 6.80) and mother (µ = 7.06; P = 0.03) as well as friend and normal-weight doctor (µ = 7.03; P = 0.04). Pairwise comparisons demonstrated differences between descriptive norm (µ = 6.79) and grocery list precommitment (µ = 7.02; P = 0.05) along with descriptive norm and injunctive norm (µ = 6.98; P = 0.04). Covariate models demonstrated main effects of race (P = 0.006) and sex (P = 0.0001). There was significant variation in the message variable and frequency of vegetable intake interaction (P = 0.01). CONCLUSIONS: Both message and messenger variables predicted the likelihood to add vegetables to meals. Race and sex influenced ratings to add vegetables. As reported vegetable consumption increased, behavioral economics messages improved the likelihood to add vegetables to meals. Behavioral economic approaches are well suited to social marketing messages that aim to promote healthy eating behavior in low-income LA residents.

Nutrition Interventions in Low-Income Rural and Urban Retail Environments: A Systematic Review.

BACKGROUND: Nutrition interventions promoting healthy food choices aim to address health challenges of residents in low-income environments. Research about the effectiveness of nutrition interventions in low-income populations is limited, particularly for those in rural areas. Behavioral economics (BE) strategies demonstrate effectiveness for improving eating behaviors in some settings. However, the efficacy of BE interventions in retail food stores serving low-income populations residing in rural and urban geographies is nascent. OBJECTIVE: This systematic literature review aims to identify and compare nutrition interventions implemented in rural and urban low-income retail food stores, including BE strategies when applied. METHODS: This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Reviewers searched five databases for peer-reviewed publications from October 2010 to October 2019. Included studies implemented a nutrition intervention in low-income retail food stores and provided a quantitative outcome evaluation with results separated by rural and urban geography. BE interventions were analyzed based on the MINDSPACE framework for behavior change. RESULTS: Forty-six separate publications (n = 20 rural, n = 26 urban) in the United States, Canada, Europe, New Zealand, and Australia were included. Researchers independently rated publications as low risk of bias (n = 4), moderate (n = 18), or high risk of bias (n = 24) using the Quality Assessment Tool for Quantitative Studies. Studies (n = 18) demonstrated positive outcomes for customer purchases, store sales, or participant intake of targeted healthy foods. Overall, most effective interventions included point-of-purchase signage (n = 16) and product placement strategies (n = 4 urban). Rural studies included financial incentives combined with participant education (n = 2) and incorporated culturally appropriate messengers and/or symbols (n = 5) to improve healthy food purchases and intake. CONCLUSIONS: Improved research quality and tailored evidence-based interventions, including BE strategies, are necessary in retail food environments to promote healthy eating behaviors in low-income populations.